摘要
目的:观察交替半身照射综合方案对急性白血病残留病的治疗效果。方法:对9例急性白血病患者经标准化疗缓解后,进行强化疗预处理(环磷酰胺120mg/kg)+交替半身照射(上半身照射7~7.5Gy,下半身照射8~9Gy)+过激免疫治疗(结核菌素纯蛋白衍生物,rhIL2激活的自体骨髓细胞)的综合方案治疗;观察指标:动态观察治疗前后的血象、骨髓象、骨髓GMCFU改变;采用筑巢式PCR检测残留病的方法和12-ο-十四烷酰佛波醋酸酯-13(12οtetradecanoylphorbol13acetateTPA)诱导分化试验观察治疗效果。结果:9例患者血象、骨髓象、骨髓GMCFU于治疗完成后2-3周均能自行恢复至正常水平,无严重毒副作用。筑巢式PCR检测表明,本组残留病4例转为阴性,2例弱阳性,3例阳性。9例患者经该方案治疗后均未作巩固化疗,现最长已持续缓解27个月,最短为4个月,中位缓解期1.5个月。结论:交替半身照射综合方案,对残留白血病有良好的治疗效果。该方案毒副作用轻,费用低,可能有推广应用前景。
Objective:This study was designed to investiga te the effect of alternative half-body irradiation combined scheme on treatment for the patients with residual disease of acute leukemia.Methods :Five patients with acute leukemia were treated with combination of con dition treatment[cytoxan(CTX)120mg /kg],alternative half-body irradiatio n(upper body irradiation with 7-7.5gray and lower body irradiation with 8-9gray),and immunotherapy(BCG-PPD,rhIL-2activing auto-bone marrow cells)after remission with standard chemo therapy.Dynamic changes of blood an d bone marrow figures,granulocyte-macrophage c olony-forming unit(GM-CFU)of bone marrow before and after treatment were observed.Reverse transcriptase polymerase c hain reaction(RT-PCR)and 12-ο-tetradecanoyl-phorbol-13-aceta te(TPA)induced differentiation assay were used to e valuate the effect.Results:In all 9cases,blood and bone marrow f igures,GM-CFU numbers of bone marrow were automati cally recovered to normal level at 2-3weeks after treatment without severe side effect.The detection of residual di sease with RT-PCR at 6months after tr eatment showed that 4negative cases,2weak positive cases,and 3positive cases had recurred at 27and 4month,respec tively.The median remission time wa s 1.5months.Conclusion:The alternative half-body irradiation combined scheme is markedly effe ctive to leukemia.Its side effect was very slight.The cost was more lower and it is easy to implement.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2001年第5期515-518,共4页
Chinese Journal of Cancer