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目的探讨以拓扑替康为主的治疗方案对难治及复发性急性淋巴细胞白血病 (ALL)的疗效及毒性反应。方法 拓扑替康联合顺铂或异环磷酰胺及阿糖胞苷治疗预后差的难治性及复发性ALL 8例。结果 经 1个疗程治疗后判断疗效 ,完全缓解 (CR) 5例 ,CR率 6 2 .5 % ;部分缓解 (PR) 1例 ,PR率 12 .5 % ;未缓解(NR) 2例 ,NR率 2 5 % ;总有效率 75 %。不良反应主要表现为白细胞及血小板明显减少的骨髓抑制。结论 拓扑替康对预后不良、难治及复发性ALL具有肯定疗效 ,是一种很有前途的治疗药物。不良反应主要为骨髓抑制 ,非血液系统毒性轻微。
Objective To investigate the efficacy and toxicity of topotecan-based regimens in patients with refractory and recurrent acute lymphoblastic leukemia (ALL). Methods Topotecan combined with cisplatin or ifosfamide and cytarabine in the treatment of poor prognosis refractory and recurrent ALL 8 cases. Results After a course of treatment, the curative effect was evaluated. Five patients were completely relieved (CR), with a CR rate of 62.5%. One patient had partial remission (PR) with a PR rate of 12.5% and two patients had no remission (NR). NR Rate of 25%; total effective rate of 75%. Adverse reactions mainly manifested as significantly reduced myelosuppression of white blood cells and platelets. Conclusion Topotecan has a positive curative effect on poor prognosis, refractory and recurrent ALL and is a promising therapeutic drug. Adverse reactions are mainly myelosuppression, non-hematological toxicity.