白细胞分离术联合化疗治疗高白细胞急性白血病疗效观察

Clinical study of leukapheresis plus chemotherapy on hyperleucocytic leukemias

目的 :对白细胞分离术联合化疗治疗高白细胞急性白血病 (HLAL)进行疗效观察。方法 :对 2 8例HLAL患者采用白细胞分离术 1～ 3次后 ,立即诱导缓解化疗 ,同时选择 15例同期HLAL患者单纯化疗作为对照 ,比较两者疗效。结果 :采用白细胞分离术 ,2 8例患者白细胞中位数由分离前的 16 5× 10 9/L下降至 38× 10 9/L ,临床症状迅速改善 ,结合化疗 ,CR率达 42 9%。明显高于单纯化疗组 ,早期病死率为 14 3% ,明显低于对照组。结论 :白细胞分离术结合化疗 ,能提高CR率。减少单纯化疗引起的不良后果。开展此疗法时 ,要注意补充血小板防止加重出血倾向。

Objective: To observe the clinical effects of leukapheresis plus chemotherapy on hyperleucocytic leukemias (HL) Methods: Twenty eight patients with hyperleucocytic acute leukemia (HLAL) underwent leukapheresis plus chemotherapy Nine HLAL patients were randomly chosen to receive chemotherapy alone Effects of the treatments on the two groups were evaluated Results: The median WBC count of the twenty eight patients decreased from 165×10 9/L to 38×10 9/L after leukapheresis Complete remission (CR) rate of the group that received leukapheresis plus chemotherapy (42 9%) was significantly higher than that of the group received chemotherapy alone (11 1%),with an improved condition and a lower risk of early mortality Conclusion: Leukapheresis plus chemotherapy can increase the CR rate and reduce side effects of chemotherapy