体外药敏试验在复发难治白血病治疗中的应用

APPLICATION OF IN VITRO SUSCEPTIBILITY TESTING IN THE TREATMENT OF RELAPSED AND REFRACTORY LEUKEMIA

目的通过体外药敏试验指导临床个体化用药治疗复发难治白血病。方法复发难治白血病患者随机分两组:按经验用药组以临床常规化疗方案进行化疗。按药敏结果指导用药组化疗前先抽取患者骨髓液分离白血病单个核细胞进行药敏试验,取敏感度强的药物组成相应的联合化疗方案,再按常规根据患者的体表面积计算剂量,并按常规方法给药。结果按药敏结果指导用药组在完全缓解(CR)率方面明显高于按经验用药组(p<0.05),在部分缓解(PR)率和未缓解(NR)率方面则未见差异。结论体外药物敏感性试验能够为临床化疗方案的选择提供参考,实现白血病化疗个体化,提高疗效,减少用药盲目性。

Objective Using in vitro drug sensitivity testing to guide clinical individualized drug treatment of relapsed or refractory leukemia. Methods Patient with relapsed or refractory leukemia were randomly divided into two groups： in the control group, participants were treated by conventional chemotherapy which is according to clinical experience. In the treatment group, drug sensitivity test was performed by extracting leukemic mononuclear cells from the bone marrow and isolating them before the chemotherapy. Combine the drugs with high sensitivity in the chemotherapy. Then calculate the dose according to body surface area and administer it using conventional method. Results The CR result in the treatment group is significantly higher than the one in the control group （p 〈 0. 05 ）. However the results of PR and NR did not have significant diversity. Conclusion Using in vitro drug sensitivity testing in clinical chemotherapy can achieve individualized chemothera- py for leukemia, improve efficacy and reduce medications being blindly.