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本文比较了儿童急性淋巴细胞白血病(ALL)成功诱导治疗后,静脉给予中等剂量氨甲喋呤(MTX)与颅脑照射二种不同方案对预防复发,延长生存期的差异。本组病例均为20岁以下初治ALL。按确诊时年龄及白细胞计数,将预后分为一般组与高险组。白细胞<3,000,年龄在2～8岁间为一般组;余为高险组。所有病人用同一VP方案诱导治疗,4周后鞘内注射MTX3次,并连续10天静注门冬酰胺酶。完全缓解(CR)后随机分为中等剂量MTX或颅脑预防照射2组。MTX组包括以MTX500mg/M~2/天,3周内给药
This article compares two different regimens of intravenous methotrexate (MTX) and cranial irradiation after successful induction therapy of acute lymphoblastic leukemia (ALL) in children to prevent recurrence and prolong survival. This group of patients are all young people under the age of 20 years old. According to age and white blood cell count at the time of diagnosis, the prognosis was divided into general group and high risk group. White blood cells <3,000, aged between 2 and 8 years old are the general group; the rest are high-risk groups. All patients were treated with the same VP regimen. MTX was injected intrathecally 4 weeks later and asparaginase was injected intravenously for 10 consecutive days. Complete remission (CR) was randomly divided into two groups: medium-dose MTX or craniocerebral prophylaxis. MTX group includes MTX 500mg/M~2/day, within 3 weeks