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目的探讨大剂量甲氨蝶呤(HDMTX)14氢叶酸钙(CF)防治髓外白血病的疗效。方法收集1998年7月至2001年6月处于完全缓解期的急性淋巴细胞白血病(急淋)住院病人42例,把他们在不同时期用不同剂量的HDMTX冲击治疗,剂量和时间为1998、1999、2000、2001年分别用HDMTX1.0、2.0、2.0-3.0、3.0g/m2.次,全部病例均经诱导缓解、巩固后进入HDMTX+CF预防髓外白血病阶段,部分病例为维持期的强化治疗。本组42例共作194例次,治疗过程中密切观察MTX毒副反应。结果追踪观察1998年至2001年上半年顺从治疗呈现持续缓解的患儿,一般情况良好,无复发迹象,能正常生活或上学。本组毒副反应偶见肝功能转氨酶升高或消化道反应,发生率为3.4%,程度轻微,均能坚持治疗。结论HDMTX3.0g/m2.次防治本地区小儿急淋髓外白血病是能耐受的,效果良好。
Objective To investigate the efficacy of high-dose methotrexate (HDMTX) 14 calcium folinate in prevention and treatment of extramedullary leukemia. Methods Forty-two patients with acute lymphoblastic leukemia (acute lymphoblastic leukemia) who were in complete remission from July 1998 to June 2001 were treated with different doses of HDMTX in different periods. The dosage and duration were 1998, 1999, 2000, 2001, respectively, with HDMTX1.0,2.0,2.0-3.0,3.0g / m2. Times, all cases were induced remission, after consolidation into HDMTX + CF prevent extramedullary leukemia stage, in some cases for the maintenance of intensive treatment . The group of 42 patients for a total of 194 cases, the treatment of close observation of MTX toxicity. Results Follow-up Observation Children with persistent remission in obstetric therapy between 1998 and the first half of 2001 were generally in good condition with no recurrence and were able to live or attend school normally. Toxic side effects of this group occasionally elevated liver function aminotransferase or gastrointestinal reactions, the incidence was 3.4%, to a lesser extent, can insist on treatment. Conclusion HDMTX3.0g / m2. Times prevention and treatment of children with acute leukemia in the region is tolerable and good effect.