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目的:评估CD33抗体为主方案治疗难治性白血病的疗效和不良反应。方法:采用CD33抗体为主方案对11例难治性白血病进行治疗。结果:CD33抗体为主方案治疗总有效率54%,其中完全缓解(CR)为36%,除血小板未完全缓解外均达到完全缓解标准(CRP)为18%,治疗后中位生存时间4.8月,缓解后中位生存时间8.2月。2例慢性粒细胞白血病急粒变均完全缓解,且BCR/ABL(-)。1例难治性急性淋巴白血病在缓解后即行异基因干细胞移植,至今无病生存已9月。不良反应有骨髓抑制(100%)、输注相关寒战发热(90%),肝静脉闭塞综合症(VOD)发生率55%,发生在干细胞移植后的患者和年龄大于60岁的患者。结论:本组资料显示CD33抗体为主方案对表达CD33的急慢性白血病有一定疗效。对于移植后复发和年龄大于60岁的患者,在使用CD33抗体时需注意患者肝脏情况,一旦出现VOD,及时处理。对于用药后缓解的患者,应尽早行异基因干细胞移植。
OBJECTIVE: To evaluate the efficacy and adverse reactions of CD33 antibody-based regimen in the treatment of refractory leukemia. Methods: 11 cases of refractory leukemia were treated with CD33 antibody. Results: The total effective rate of treatment with CD33 antibody was 54%, of which 36% achieved complete remission (CR) and 18% achieved complete remission (CRP) except for platelet remission. The median survival time after treatment was 4.8 months , Median survival time after remission 8.2 months. Two cases of acute myelogenous leukemia acute remission were completely relieved, and BCR / ABL (-). One case of refractory acute lymphoblastic leukemia after transplantation in allogeneic stem cell transplantation, so far disease-free survival has been 9 months. Adverse reactions were bone marrow suppression (100%), infusion-related cholerrhea (90%), and hepatic veno-occlusive syndrome (VOD) with a 55% incidence in patients after stem cell transplantation and in patients older than 60 years. Conclusion: This group of data show that the main program of CD33 antibody expression of CD33 acute and chronic leukemia have a certain effect. For post-transplant relapse and patients older than 60 years of age, use of CD33 antibodies should pay attention to the patient’s liver condition, in the event of VOD, timely treatment. For patients with remission after treatment, allogeneic stem cell transplantation should be carried out as soon as possible.