三氧化二砷联合化疗治疗难治性及复发性恶性血液病的临床疗效观察

Clinical observation of the combination of arsenic trioxide and standard-does chemotherapy for the treatment of drug resistance and relapse hematological malignancies

目的 :观察三氧化二砷 (As2 O3 )联合化疗治疗难治性及复发性恶性血液病的疗效和不良反应。方法 :As2 O3 联合蒽环类药物、阿糖胞苷及足叶乙甙治疗难治性及复发性恶性血液肿瘤患者 33例 ,治疗方法是用As2 O3 (0 .1%溶液 ) 10ml加入 5 %葡萄糖溶液 5 0 0ml中静脉滴注 3～ 5h ,每天 1次 ,共治疗 30天 ;对复发性早幼粒细胞白血病、加速期慢性粒细胞白血病及骨髓增生异常综合征患者用As2 O3 联合柔红霉素 4 5mg·m-2 ·d-1× 3天加阿糖胞苷 10 0mg/m2 q12h× 7天治疗 ;对进展期多发性骨髓瘤和ⅢB～Ⅳ期非霍奇金淋巴瘤患者用As2 O3 联合米托蒽醌 8～ 10mg·m-2 ·d-1× 3天加足叶乙甙 6 0mg·m-2 ·d-1× 5天加Pred 1mg/kg× 7天加长春新碱 2mg× 1天治疗。结果 :33例患者中 ,19例获得完全缓解 (CR) ,2 7例有效 ,CR率为 5 7.8% ,有效率为 81.8%。结论 :As2 O3 联合化疗治疗难治性及复发性恶性血液病疗效好 。

Objective:To observe the efficacy and side effect of the arsenic trioxide combining standard does chemotherapy in treatment of drug resistance and relapse hematological malignancies.Method:thirty three patients were treated with arsenic trioxide combining standard does chemotherapy. the treatment protocol was as following:10 mg As 2O 3 (0.1%solution)in 500 ml 5%glucose solution for intravenous drip over 3 to 5 hours once a day.The relapse acute promyelocytic leukemia.(APL) ,accelerated phase chronic myeloid leukemia(CML AP) and myelodysplastic syndromes refractory anemia with excess blasts in transformation(MDS RAEBT) patients are treated with daunorubicin 45 mg·m -2 ·d -1 ×3 d+cytarabine 100 mg/m 2 q12h ×7 d. Evolutional Multiple Myeloma and ⅢB ⅣNon Hodgkin’s lymphomas patients are treated with mitoxantrone(8～10)mg·m -2 ·d -1 ×3 d+ Etoposide 60 mg·m -2 ·d -1×5 d+ Pred 1 mg/kg×7 d+Vincristine 2 mg×1 d.Result:nineteen patients achieved complete remission(CR),the CR rate was 57.8 %,treatment effective rate was 81.8 %.Conclusion:the As 2O 3 combined with standard does chemotherapy for the treatment of drug resistance and relapse hematological malignancies showed a higher CR without intolerable side effects.