大剂量甲氨喋呤治疗成人急性淋巴细胞白血病

High-dose methotrexate for acute lymphoblastic leukemia

目的观察大剂量甲氨喋呤(MTX)联合柔红霉素、长春新碱、环磷酰胺、强的松治疗成人急性淋巴细胞性白血病的效果及毒副作用。方法观察12例成人急性淋巴细胞性白血病患者,给予MTX3g/m2联合柔红霉素、长春新碱、环磷酰胺、强的松化疗,同时给予水化、碱化、止吐、保肝、补充能量和液体、生理盐水清洁口腔、防止感染等支持治疗。结果完全缓解(CR)率58.3%,部分缓解(PR)率25.0%,总有效率83.3%。6例中枢神经系统白血病患者5例脑脊液缓解,缓解率83.3%;毒副作用较小。结论大剂量甲氨喋呤联合柔红霉素、长春新碱、环磷酰胺、强的松治疗成人急性淋巴细胞性白血病是一种安全有效的方案。

Objective To investigate the effectiveness and toxicity of high - dose methotrexate combined with daunorubicin, vincristine, cyclophosphamide and prednisone for adult acute lymphoblastic leukemia. Methods The study recruited 12 adult patients with acute lymphoblastic leukemia. Chemotherapy consisted of MTX （3g/m^2）, daunorubicinin, vincristine, cyclophosphamide and prednisone. Support treatment was as follows： hydration, alkalization, antiemetic, liver protection, and infection prevention etc. Results Complete remission rate （CR） was 58.3%, partial remission rate （PR） was 25.0%, with total response rate being 83.3%. Of 6 patients with central nervous system leukemia, 5 patients achieved CSF remission, with a remission rate being 83.3%. There was little adverse reaction. Conelusion High - dose methotrexate in combination with daunorubicin, vincristine , cyclophosphamide and prednisone is safe and effective for adult acute lymphoblastic leukemia.