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目的探讨用白细胞去除术加联合化疗、羟基脲 (HU)加联合化疗及单用联合化疗治疗高白细胞急性白血病(HAL)疗效的差别。方法将 5 3例HAL随机分为 3组 ,HAL 1组和HAL 2组分别先行白细胞去除和口服Hu ,显著降低白细胞后再行联合化疗 ,HAL 3组单用联合化疗 ,观察各组疗效及不良反应。 30例非高白细胞急性白血病 (NHAL)单用联合化疗作为对照组。结果HAL 1组与HAL 2组间完全缓解 (CR)率、早期病死率无显著差异 ,白细胞去除和口服HU无严重不良反应 ,其CR率均显著高于HAL 3组 (P <0 .0 5 ) ,而早期病死率低于后者。结论白细胞去除术及HU口服对降低HAL患者的白细胞是有效、安全的 ,随后行联合化疗可显著提高疗效。
Objective To investigate the differences between the treatment of leukemic acute leukemia (HAL) with leukocyte depletion combined with chemotherapy, hydroxyurea (HU) combined with chemotherapy and single combined chemotherapy. Methods Fifty-three HALs were randomly divided into three groups. HAL-1 group and HAL-2 group were treated with leukocyte removal and oral administration of Hu, leukocyte reduction was followed by combination chemotherapy, and HAL 3 group was treated with combination chemotherapy alone. reaction. Thirty non-Hyperacute leukemia (NHAL) single combined chemotherapy as control group. Results There was no significant difference in complete remission (CR) rate and early mortality between HAL 1 group and HAL 2 group. There was no serious adverse reactions of leukocyte removal and oral HU, and the CR rates of HAL 1 group were significantly higher than those of HAL 3 group (P <0.05) ), While the early mortality rate is lower than the latter. Conclusion Leukopenia and HU oral administration are effective and safe for reducing leukocytes in patients with HAL, followed by combined chemotherapy can significantly improve the efficacy.