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目的 探讨急性髓性白血病 (AML)体内、外联合化疗方案的敏感性及药物间的相互关系 ,为临床治疗提供最有效的化疗方案。方法 采用MTT体外药敏法 ,利用倍增模型分析法和最大限度模型分析法研究体外化疗药物间的相互作用关系及对白血病细胞的敏感性 ,并观察体内、外药物敏感性的关系。结果 在 5 7例AML中体外对HA方案敏感 35例 (6 1% ) ,对DA方案敏感 33例 (5 8% ) ,对MA方案敏感 33例 (5 8% ) ;HA协同或相加作用占 72 % ;DA协同或相加作用占 74 % ;MA协同或相加作用占 74 % ;经临床治疗有结果可判断疗效的共同 39例 ,S/S19例 ,S/R6例 ,R/R11例 ,R/S3例 (S :敏感 ,R :耐药 ,体内 /体外 ) ,体内、外总符合率 76 .9%。结论 联合化疗方案HA、DA、MA是治疗AML患者的有效方案 ,化疗药物间大多数是起相互协同作用或相加用用 ,少数为拮抗作用 ,通过体外药物敏感试验发现三种常用化疗方案相互作用起协同或相加作用占 70 %以上 ,与临床缓解率相近 ,故选择敏感化疗方案是提高缓解率的有效办法。
Objective To investigate the sensitivity and drug-drug interaction of acute and myelogenous leukemia (AML) in vitro and in vivo and to provide the most effective chemotherapy regimen for clinical treatment. Methods MTT in vitro susceptibility assay was used to study the interaction between chemotherapeutic drugs in vitro and the sensitivity to leukemia cells by using the double model analysis and the maximum model analysis. The relationship between drug sensitivity in vitro and in vivo was also observed. Results In 57 AML cases, 35 (61%) were sensitive to HA, 33 (58%) were sensitive to DA, 33 (58%) were sensitive to MA, HA synergistic or additive Accounting for 72%; DA synergistic or additive effect accounted for 74%; MA synergistic or additive effect accounted for 74%; clinical treatment of the results can be judged by the common 39 cases, S / S 19 cases, S / R6 cases, R / R11 Cases, R / S3 cases (S: sensitive, R: drug resistance, in vivo / in vitro), both in vivo and externally consistent rate of 76.9%. Conclusions Combination chemotherapy regimen HA, DA and MA are effective regimens for the treatment of AML patients. Most of the chemotherapeutic drugs play a synergistic or additive role with each other, and a few are antagonistic. Through the drug sensitivity test in vitro, the three commonly used chemotherapy regimens The role of synergistic or additive effect accounted for more than 70%, and clinical remission rate is similar, so the choice of sensitive chemotherapy is an effective way to improve the remission rate.