大剂量阿糖胞苷治疗儿童急性淋巴细胞白血病和恶性淋巴瘤

High-dose Cytosine Arabinoside Therapy for Childhood Lymphoblastic Leukemia and Non-Hodgkin's Lymphoma

17例儿童急性淋巴细胞白血病和Ⅳ期T细胞型恶性淋巴瘤，于诱导治疗获完全缓解（CR）后，给以大剂量阿糖胞甙（HDAra－C）为主的联合方案作早期强化治疗及中枢神经系统白血病（CNSL）预防，然后继续进行长期系统化疗。目前，其中15例（88．2％）继续CR，已有3例CCR＞3年。1例失访，仅1例因故未能行系统维持和定期强化治疗而复发。无1例并发CNSL。HDAra－C治疗后骨髓抑制严重，经采用综合防治措施后，感染率仅27．1％，无1例因化疗相关死亡。未见肝肾、神经系统及其它明显毒性反应。

Seventeen cases of childhood acute lymphoblastic leukemia and stage Ⅳ T cell malignant lymphoma were treated with high-dose cytosine arabinoside (HDAra-C) as early intensive chemotherapy as well as prevention of central nervous system leukemia following complete remission (CR) after prolonged inductive systemic chemotherapy. To date, 15 cases remained in state of CR,of which 3 cases has been in CR for more than 3 years and,beside one case lost to follow-up,only one patient relapsed who had failed to recieve systemic and periodic intensified chemotherapy. No patient was complicated with CNSL. There was severe myelosuppression after administration of HDAra-C, but infection was documented in only 27. 1% as a result of comprehensive preventive management. No evidence of liver,renal or central nervous system toxicity were observed,and no chemotherapyrelated death occurred.