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体外试验已显示光神霉素(plicamycin)为强有力的 HL-60细胞的分化诱导剂。而羟墓脲(hydroxyurea,HU)本身也是一种弱的诱导剂。已证明两者联合应用对红白血病患者的细胞分化有协同作用。本文报告用光神霉素和 HU 联合治疗慢粒急变期的效果。9例慢粒急变患者中,8例 Ph~1染色体阳性,年龄20～59岁。按原始细胞的形态分类,6例属急粒变(其中1例开始为急粒变,后转化为急淋变),2例属急淋变,另1例属非粒非淋样急性变。他们在治疗前大都用过马利兰或/和 HU。其中3例为接受过长春新碱和强的松治疗的难治患者。用光神霉素25μg/kg,加入250～500ml 5%葡萄糖液中滴注,维持2～4小时,隔天1次,持续3周;并每天口服 HU,剂量按白细胞(WBC)计数的高低而调整;WBC>10万,4g/d;WBC>7.5万,3g/d;WBC>5万,2g/d;WBC>3万,1.5g/d;WBC>1.5万,1g/d;WBC>
In vitro experiments have shown that plicamycin is a potent inducer of differentiation of HL-60 cells. The hydroxyurea (hydroxyurea, HU) itself is also a weak inducer. It has been demonstrated that the combination of the two has a synergistic effect on cell differentiation in patients with erythroleukemia. This article reports the efficacy of a combination of mithramycin and HU in the treatment of acute phase of chronic phase. Among the 9 patients with chronic granulomatous blast crisis, 8 Ph ~ 1 chromosomes were positive and were between 20 and 59 years old. According to the morphological classification of primary cells, 6 cases were acute granuloma (one of them started acute granuloma and then became acute lymphadenosis), 2 cases were acute lymphadenopathy and the other one was non-granulo-non-acute. They mostly used Maryland or / and HU before treatment. Three of these patients were refractory to vinblastine and prednisone treatment. With mithramycin 25μg / kg, add 250 ~ 500ml 5% glucose solution instillation, maintained for 2 to 4 hours, every other day for 3 weeks; and daily oral HU, the dose according to the level of white blood cell (WBC) count WBC> 50 000, 2 g / d; WBC> 30 000, 1.5 g / d; WBC> 15 000, 1 g / d; WBC> >