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作者观察3例确诊为亚急性粒单细胞白血病(sMML)病人,年龄63-66岁,在疾病开始即出现明显的皮损,皮肤活检提示单核细胞浸润,同时存在肾衰。行强烈诱导化疗:柔红霉素60mg/m~2、i·v/第1天;博来霉素15mg/m~2、i·v,第1和第5天;阿糖胞苷100mg/m~2、i·v,1-5天;VP_(16)100mg/m~2、i·v、1-5天。所有病人都在第一疗程后达到完全缓解(CR),皮损消失,肾功恢复。巩固治疗:用上述方案每隔3周1次,共2疗程。维持治疗:用TRAP联合3疗程、POMP联合3疗程、最后3次遵照Spiers方案用VP~(16)(100mg/m~2、i·v,1-3天)和阿糖胞苷(150mg/m~2/12小时,S·C,1-3天)共3疗程。2例在CR的18个月和9个月复发,并在很短时间内死
The authors observed three cases of subacute granulocytic leukemia (sMML) patients, aged 63-66 years old, with obvious skin lesions at the onset of the disease. Skin biopsy revealed mononuclear cell infiltration and renal failure. Intensive induction chemotherapy: daunorubicin 60 mg/m~2, i•v/day 1; bleomycin 15 mg/m~2, i•v, days 1 and 5; cytarabine 100 mg/ m~2, i•v, 1-5 days; VP_(16) 100 mg/m~2, i•v, 1-5 days. All patients achieved complete remission (CR) after the first course of treatment, skin lesions disappeared, and renal function recovered. Consolidation treatment: Use the above protocol once every 3 weeks for a total of 2 courses. Maintenance therapy: TRAP in combination with 3 courses of treatment, POMP in combination with 3 courses of treatment, last 3 sessions of compliance with Spiers protocol with VP 16 (100 mg/m 2 , i v, 1-3 days) and cytarabine (150 mg/ m~2/12 hours, S·C, 1-3 days) total 3 courses. 2 patients relapsed at 18 months and 9 months of CR and died within a short period of time