替尼泊苷联合方案治疗交叉表达双系相关抗原急性白血病的临床研究

A CLINICAL STUDY OF TENIPOSIDE-BASED COMBINATIVE CHEMOTHERAPEUTIC REGIMENS IN THE TREATMENT OF ACUTE LEUKEMIA CROSS-EXPRESSING LINEAGE-ASSOCIATED ANTIGEN

目的 :探讨替尼泊苷联合方案治疗交叉表达淋系和髓系抗原急性白血病的化疗疗效。方法 :应用替尼泊苷联合阿糖胞苷、环磷酰胺、长春地辛及泼尼松组成 TA或 TA+COP方案 ,治疗伴淋系抗原表达的急性髓细胞白血病 (L y+ AML) 2 4例和伴髓系抗原表达的急性淋巴细胞白血病(My+ AL L) 1 7例。结果 :完全缓解 (CR)率为 5 6 .1 % (2 3/ 4 1 ) ,总有效率为 80 .5 % (33/ 4 1 )。与常规方案 (DA、VDL P)诱导疗效相比有显著性差异 (P<0 .0 1 )。其中 L y+ AML 的 CR率为 5 8.3% ,总有效率为 79.2 % ;My+ AL L 的 CR率为 5 2 .9% ,总有效率为 82 .4 %。复治性 L y+ AML / My+ AL L 总有效率为 72 .7% (8/ 1 1 )。两种方案的骨髓抑制明显 ,毒副作用能够耐受。结论 :L y+ AML 和 My+ AL L不宜采用常规诱导缓解方案 ,TA和

Objective:To summarize the curative effectiveness of teniposide based combinative chemotherapeutic regimens in the treatment of acute leukemia expressing additional differentiation antigens.Methods:A panel of 41 patients with acute myeloid leukemia expressing lymphoid markers (Ly +AML) and acute lymphoblastic leukemia expressing myeloid markers (My +ALL) were treated with TA (teniposide and cytarabine) and TACOP (TA+CTX+VDS+Pred) regimens.Results:There were about 56.1% of the 41 cases of patients gain a complete remission (CR), and the total remission (TR) rate is 80.5 %(33/41).There was significant difference of therapeutic effect between VM26 based regimen group and conventional protocol group. The CR rate and TR rate were 58.3 % and 79.2 % for Ly +AML and 52.9 % and 82.4 % for My +ALL, respectively. The TR rate of refractory Ly +AML/My +ALL was 72.7 % (8/11). Both the chemotherapeutic remedies displayed an obvious yet tolerable marrow suppressive toxicity.Conclusion: Ly +AML and My +ALL patients are not suitable for utilizing conventional treatment protocols to induce remission, whereas TA and TACOP regimens should be considered as the primary chemotherapeutic treatment for these patients.