以吡柔比星为主的联合化疗方案治疗急性淋巴细胞白血病72例临床分析

Clinical analysis of pirarubicin-based combined chemotherapy regimen in the treatment of 72 cases of acute lymphoblastic leukemia

目的探讨以吡柔比星为主的联合化疗方案治疗急性淋巴细胞白血病的疗效及不良反应。方法回顾性分析郑州大学第一附属医院血液科2006年1月至2010年1月住院治疗的急性淋巴细胞白血病患者72例,均接受了以吡柔比星为主的化疗方案治疗,其中初治组11例,复发难治组8例,强化组53例。结果初治组中以吡柔比星为主的联合化疗方案诱导缓解治疗1疗程的完全缓解率为72.7%;难治复发组中以吡柔比星为主的治疗方案治疗1疗程的完全缓解率为37.5%;强化治疗组中,应用以吡柔比星为主的化疗方案治疗后仍处于完全缓解者占88.7%,应用含吡柔比星化疗方案后2个月内11.3%复发。吡柔比星的主要不良反应是骨髓抑制,其他的心脏毒性,肝肾功能损害多可以耐受。结论以吡柔比星为主的化疗方案用于初治及复发急性淋巴细胞白血病的诱导缓解治疗及缓解后治疗,疗效显著且不良反应多可以耐受。

Objective To explore the efficacy and side-effect of pirarubicin-based combined chemotherapy regimen in the treatment of acute lymphoblastic leukemia.Methods Retrospective analysis was performed in 72 cases of acute lymphoblastic leukemia,who were hospitalized in department of hematology,the First Affiliated Hospital of Zhengzhou University,from January 2006 to January 2010 and treated with pirarubicin-based combined chemotherapy regimen.Of them,11 were new cases,8 were relapsing or refractory cases,and 53 were in complete remission（CR）.Results With pirarubicin-based combined chemotherapy regimen,the newly diagnosed cases had a CR rate of 72.7% and the relapsing/refractory cases had a CR rate of 37.5%,after one course of treatment with pirarubicin-based combined chemotherapy regimen.When pirarubicin-based combined chemotherapy regimen was administrated to the patients who were CR as post remission therapy,there were 88.7% cases still in CR,but 11.3% cases relapsed during two months of follow-up.The main side-effects of pirarubicin was bone marrow suppression.The non-bone marrow side-effects were tolerable,such as damage to the liver and renal function,heart toxicity.Conclusions Pirarubicin-based combined chemotherapy regimen has significant efficacy in the treatment of ALL,for initial treatment,relapsing treatment and intensive treatment,and the side effects were well tolerable.