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目的探讨hyper-CVTD/MA方案治疗中高危以上淋巴瘤及复发、难治急性淋巴细胞白血病的疗效和不良反应。方法中高危以上非霍奇金淋巴瘤25例,复发难治急性淋巴细胞白血病18例采用hyper-CVTD/MA方案化疗:环磷酰胺300mg/m2,每12小时1次,第1～3天,持续2h静滴;长春新碱1.4mg/(m2.d),第4,11天,持续24h静滴;吡柔比星50mg/(m2.d),第4天,静注;地塞米松20～40mg/(m2.d),第1～4天和第11～14天,静滴;MA方案:甲氨碟呤1.0g/(m2.d),第1天,持续24h静滴;阿糖胞苷1.0g/m2,每12小时1次,第2～3天,持续4h静滴。结果恶性淋巴瘤组完全缓解12例,部分缓解6例,稳定2例,死亡5例;急性淋巴细胞白血病组完全缓解9例,部分缓解3例,未缓解2例,死亡4例。副作用中胃肠道反应31例(72.09%)、感染32例(74.42%)、黏膜炎33(76.74%)、肝脏功能损害24(55.81%)、心脏毒性9(20.93%)。结论 hyper-CVTD/MA是治疗恶性淋巴系血液病的有效方案,积极预防及处理并发症。
Objective To investigate the efficacy and adverse reactions of hyper-CVTD / MA regimen in the treatment of middle and high risk lymphomas and recurrent and refractory acute lymphoblastic leukemia. Methods High-risk non-Hodgkin’s lymphoma in 25 cases, relapsed-refractory acute lymphoblastic leukemia in 18 cases using hyper-CVTD / MA regimen: cyclophosphamide 300mg / m2, every 12 hours, 1 to 3 days, Vinblastine 1.4mg / (m2.d), the first 4,11 days, continuous 24h infusion; pirarubicin 50mg / (m2.d), the first 4 days, intravenous; dexamethasone 20 ~ 40mg / (m2.d), the 1st to 4th days and the 11th to 14th days, intravenous drip; MA regimen: methotrexate 1.0g / (m2.d) Cytarabine 1.0g / m2, every 12 hours 1, 2 to 3 days, sustained 4h intravenous infusion. Results In the group of malignant lymphoma, complete remission was achieved in 12 cases, partial remission in 6 cases, stable in 2 cases and death in 5 cases. In acute lymphoblastic leukemia group, 9 cases were completely relieved, 3 cases partially relieved, 2 unrelated and 4 died. There were 31 cases (72.09%) of gastrointestinal reactions, 32 cases (74.42%) were infected, 33 (76.74%) were mucositis, 24 (55.81%) were liver damage, and 9 (20.93%) were cardiotoxic. Conclusion Hyper-CVTD / MA is an effective treatment for malignant lymphatic system blood diseases, and it can prevent and treat complications.