大剂量环孢霉素A联合G-CSF预激逆转耐药的研究

Study on Drug Resistance Inversion by High Dose CsA Plus G - CSF Pre - stimulating

目的 研究临床逆转白血病细胞对化疗药物耐药的治疗策略。方法 根据环孢霉素逆转耐药的原理,采用大剂量环孢霉素A(CsA)以提高白血病细胞内药物浓度,结合粒细胞集落刺激因子(G-CSF)预先刺激白血病细胞从静止期进入细胞周期,以及选择蒽醌类加小剂量阿糖胞苷(Ara-c)的化疗方案,对10例原发耐药和复发耐药的急性髓细胞性白血病患者进行治疗,并用MTT法比较逆转前后各类药物对细胞抑制率的变化。结果 治疗后各类药物对细胞的抑制率有明显上升。10例病人中,4例获缓解,3例部分缓解,3例未缓解。结论 大剂量环孢霉素A联合G-CSF预激化疗可作为难治性白血病或复发病人的选用方案。

Objective To study the therapy strategy of inverting drug resistance in leukemia. Methods We used drug resistance inversion method to treat 10 patients. High dose cyclosporin A(CsA) is used as inversion drug to raise drug concentration inside leukemia cells. Granulocyte colony - stimulating factor ( G -CSF) was applied to pre -stimulate leukemia cells from resting phase into cell cycle. We also use mitoxantrone plus low dose Ara - C as chemotherapy regimen. Then we compared cells inhibition rate by different drugs before and after inverting treatment with MTT method. Results Among 10 patients, 4 patients achieved completely remission( CR) ,and the CR rate was 40% ;3 patients achieved partial remission (PR) , 3 patients did not gain remission. Our laboratory examination result also showed that the inhibition rate of cell by different drugs increased after inverting treatment. Conclusion This treatment can be applied for patients with drug resistant or relapsed leukemia.