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目的探讨米托蒽醌(MTZ)在急性淋巴细胞白血病(ALL)化疗中的作用特点。方法50例CD3+4抗原高表达的ALL,随机选择二种化疗方案(COMP,CODP),联合化疗1个疗程后分别比较CR率、骨髓抑制及其他毒副作用;同时将骨髓白血病细胞体外培养72h,进行药物杀伤效应实验,分别比较MTZ、柔红霉素(DNR)在体外对ALL细胞不同分化阶段的抑制作用。结果CD34抗原高表达的ALL中,以MTZ为主的COMP方案的1个疗程缓解率为92.6%,比CODP方案高27.4%。体外白血病细胞培养加药物抑制试验结果显示,MTZ对分化较早阶段的CD3+4ALL细胞的抑制显著高于DNR。结论MTZ对ALL具有较强的抗白血病活性,临床骨髓抑制明显。上述特点可能与其主要作用于白血病细胞的分化较早阶段有关。
Objective To investigate the role of mitoxantrone (MTZ) in the chemotherapy of acute lymphoblastic leukemia (ALL). Methods Fifty patients with high expression of CD3 + 4 antigen and two chemotherapy regimens (COMP and CODP) were randomly selected. The rates of CR, myelosuppression and other toxicities and side effects were compared after one course of chemotherapy. The myeloid leukemia cells were cultured in vitro for 72h , The effect of drug-killing effect experiments were compared MTZ, daunorubicin (DNR) in vitro differentiation of ALL cells in different stages of inhibition. Results Among the ALL patients with high expression of CD34 antigen, the MT response of COMP group was 92.6%, which was 27.4% higher than that of CODP. In vitro leukemia cell culture plus drug inhibition test results show that, MTZ on the early stage of differentiation of CD3 + 4 ALL cells was significantly higher than DNR. Conclusion MTZ has a strong anti-leukemia activity against ALL, with significant clinical bone marrow suppression. These features may be related to its role in the early stages of leukemia cell differentiation.