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目的 :探讨大剂量阿糖胞苷 ( HDAC)治疗儿童急性白血病的效果和不良反应。 方法 :应用 HDAC治疗 3例急性髓细胞白血病 (每次 2 .0 g/m2 ,每 12 h1次 ,共 6次为一个疗程 )和 4例高危型急性淋巴细胞白血病 (每次1.0 g/m2 ,每 12 h1次 ,共 8次为一个疗程 )共 16个疗程 ,九个疗程在 HDAC结束后使用惠尔血 ( 2～ 3μg/kg)皮下注射 ,连续 10～ 14天。 结果 :6例按计划完成 HDAC治疗 ,并继续用常规方案治疗者 ,在 2 0～ 42个月的随访期内无病生存 ,1例 AL L- L3型在一个疗程 HDAC后出现中枢神经系统白血病复发 ,骨髓仍缓解 ,7个月后放弃治疗 .骨髓严重抑制和感染是最主要的不良反应 ,加用惠尔血可使粒细胞缺乏的持续时间缩短 ,感染发生率降低。 结论 :以 HDAC为主的联合化疗方案可安全地用于儿童急性白血病的强化治疗 ,对降低复发、提高无病生存率有积极意义
Objective: To investigate the effect and side effects of high-dose cytarabine (HDAC) in children with acute leukemia. Methods: Three cases of acute myeloid leukemia (2.0 g / m2 each time, once every 12 hours for 6 courses) were treated with HDAC and 4 high-risk acute lymphoblastic leukemia (1.0 g / m2 each time) Every 12 h1 times, a total of 8 times for a course of treatment) a total of 16 courses, nine courses of HDAC after the end of the use of blood (2 ~ 3μg / kg) subcutaneous injection for 10 to 14 days. Results: Six patients underwent HDAC as planned and continued to receive treatment with conventional regimens without disease-free survival within the follow-up period of 20 to 42 months. One patient with AL-L3 type developed central nervous system leukemia after one course of HDAC Recurrence, bone marrow is still remission, to give up treatment after 7 months.Magnetic bone marrow suppression and infection is the most important adverse reactions, plus the Whirlpool can reduce the duration of agranulocytosis, reduce the incidence of infection. Conclusion: HDAC-based combination chemotherapy can be safely used in the intensive treatment of acute leukemia in children and has a positive effect on reducing relapse and improving the disease-free survival rate