大剂量甲氨蝶呤治疗儿童急性淋巴细胞性白血病报导

A report of HDMTX treating for children Acnte lymphoblastic leukemia(ALL)

目的探讨大剂量甲氨蝶呤(HDMTX)14氢叶酸钙(CF)防治髓外白血病的疗效。方法收集1998年7月至2001年6月处于完全缓解期的急性淋巴细胞白血病(急淋)住院病人42例,把他们在不同时期用不同剂量的HDMTX冲击治疗,剂量和时间为1998、1999、2000、2001年分别用HDMTX1.0、2.0、2.0-3.0、3.0g/m2.次,全部病例均经诱导缓解、巩固后进入HDMTX+CF预防髓外白血病阶段,部分病例为维持期的强化治疗。本组42例共作194例次,治疗过程中密切观察MTX毒副反应。结果追踪观察1998年至2001年上半年顺从治疗呈现持续缓解的患儿,一般情况良好,无复发迹象,能正常生活或上学。本组毒副反应偶见肝功能转氨酶升高或消化道反应,发生率为3.4%,程度轻微,均能坚持治疗。结论HDMTX3.0g/m2.次防治本地区小儿急淋髓外白血病是能耐受的,效果良好。

Objective To observe the effect of HDMTX preventing ALL patients from out bone morrow leukemia(OBML).Methods42CR cases of all were observed from7,1998to6,2001.all of them were to be freated with HDMTX and careful-ly obserred the toxic-aside effect.They might re-ceive MTX with different dose in different period:1.0g/m 2 ,1998;2.0g /m 2 ,1999;2.0-3.0g /m 2 ,2000;3.0g /m 2 ,2001.194times of therapy were given in all on the whole group.Rusults By the time Ju-ly2001,all of therapy obedient patients were con-tinued complete remission(CCR)with good condi-tion and no evidence of recidivation.Slightly high-er SGPT or(and)SGOT and gastrointestinal reaction were the main toxic -aside effect most of them could continue to be treated.The toxic-aside effect rate was3.4%.Conclusion To prevent OBML,the MTX dose of3.0g /m 2 is effective and re-sistible.