大剂量阿糖胞苷在小儿白血病巩固治疗中的不良反应

clinical observation of the high dose cytoarabinose adverse effects in the cOnsolidation treatment of children with acute leukemia

总结在以大剂量阿糖胞苷 (HDAraC)为主的联合化疗方案对儿童急性白血病进行巩固诱导治疗过程中的不良反应 ,以及化疗的综合防治处理效果。对28例急性白血病患儿 (急性淋巴细胞白血病22例 ,非霍奇金淋巴瘤6例 )于诱导治疗获完全缓解 (CR)后 ,使用以HDAraC为主的联合方案 (每次HDAraC2.0g/m2) ,累计79例次进行巩固诱导治疗过程中出现的不良反应以及化疗的综合防治处理效果进行总结。结果在AraC累积剂量≤24g/m2 的条件下 ,其神经毒性较轻而且可逆 ;骨髓抑制、呕吐、药物热及皮疹等是常见的不良反应 ,在采用相应的辅助措施后即获缓解。肝脏、肾脏、心脏等受损极少。提示在HD -AraC治疗过程中采用积极有力的综合防治措施 ,可以使患儿安全完成巩固诱导治疗。

in order to understand the adverse effects of the intensive consoLiDation induction chemotherapy with high dose cytoarabinose(hdarac)as the main DRug in children with acute leukemia and the results of the comprehensive preˉveNtion measures to deal with such adverse effects,28children with hematological MAlignancies(22children with acute lymphoblastic leukemia,6with non_hodgkin's lYmphoma)received this intensive combined chemotherapy with hdarac as the main dRug when they obtained complete remission(cr)with the induction therapy(hdaraC2.0g/m 2 /each time iv).79case times have been piled up for this intensive comBined consolidation therapy to observe the adverse effects and the results of thE comprehensive prevention measures to treat such adverse effects.the results inDicated that the neurotoxicity(13/79,16.5%)is mild and reversible,when the aCcumulated dosage of hdarac are under24g/m 2 .the marrow suppression(79/79,100%),vomiting(45/79,56.6%),drug related fever and skin rashes are the common side effects and could be controlled with the comprehensive prevention measures,while the toxicity to the liver,kidney and heart is rare(0/79)inˉdicating THese adverse effects could be reduced with the comprehensive prevention measures.so,these children could safely complete this intensive consolidation induction therapy.