替尼泊苷在儿童急性淋巴细胞白血病中的应用

Clinical application of teniposide(VM 26 )in the treatment of children with acute lymphoblastic leukemia(ALL)

替尼泊苷 (VM26)为半合成的鬼臼毒素的糖基衍生物 ,在儿童多用于治疗急性淋巴细胞白血病 (ALL)。为探讨ALL在巩固、早期强化及维持加强化疗阶段应用VM26+Ara_C前后血常规变化规律 ,对155例次ALL患儿应用VM26+Ara_C治疗前、后血常规变化情况进行统计分析。结果 :用药后白细胞、血小板于第11～13天降到最低值 ,于3周恢复正常。注射G_CSF对白细胞的恢复有作用。提示VM26 对骨髓的抑制作用是其主要副作用 ,为保证化疗的顺利、安全进行 ,临床医师应了解其对骨髓的影响程度 ,从而有效地发挥其抗癌作用。

VM 26 in one of the semi_synthetic glycosylated derivatives of podophyllotoxin often used to treat children with ALL.In order to explore the dynamic changes of the blood routine examination happened in the consolidation,early intensification and continuation chemotherapy periods with VM 26 as the main drug in combination therapy,blood routine examinations were performed before and after this combination therapy in155children with ALL.The results showed the WBC and,platelet counts decreased to the lowest level on the11_13th days of chemotherapy and returned to the normal level in3weeks.But G_CSF injection played a positive role in the WBC recovery,indicating the main side_effect of VM 26 plus Ara_C combined chemotherapy is the marrow suppression.To ensure such combined therapy can be given safely and smoothly,clinicians should understand the severity of the marrow suppression and the dosage of this drug should be adjusted inˉdividually according to the tolerance of the patients.In addition,the effective measures should be taken to reduce the severity of this side_effect.In this way,the anti_cancer effect of this combination chemotherapy can be put into full play.