甲氨蝶呤含化疗方案治疗儿童未分化非霍奇金淋巴瘤和B细胞急性淋巴细胞白血病的评价。

I J Hung, C P Yang
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引用次数: 0

摘要

从1983年9月到1988年10月,13例伯基特或非伯基特型未分化非霍奇金淋巴瘤(NHL)和3例B细胞急性淋巴母细胞白血病接受了多种多药化疗方案的治疗,其中含有中剂量至高剂量的甲氨蝶呤(HDMTX)输注。所有患者均为2岁8个月至14岁1个月的儿童。该小组包括13名男孩和3名女孩。淋巴瘤主要位于头颈部,5;腹部,7;淋巴结,1。诊断时临床分期为I期、1期;第二阶段,6个;第三阶段,3个;第四阶段,3。MTX输注剂量范围为300 ~ 4285 mg/M2,患者总累积剂量范围为750 ~ 30168 mg/M2。除62例300 mg/M2输注MTX外,所有MTX输注后均给予Citrovorum Factor Rescue。在所有HDMTX治疗后监测血清MTX水平。对化疗相关毒性进行分级分析。确定并讨论了可能易患hdmtx相关毒性的临床特征。我们的数据揭示了住院患者和患者间MTX动力学的变化。没有与药物相关的死亡,患者的总体结果令人满意。我们得出结论,MTX输注在目前儿童B细胞恶性肿瘤的治疗中继续发挥重要作用;然而,障碍仍然存在,特别是对于那些广泛存在的B细胞疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of methotrexate containing chemotherapeutic regimens in the treatment of childhood undifferentiated non-Hodgkin's lymphoma and B cell acute lymphoblastic leukemia.

From September 1983 to October 1988, 13 undifferentiated non-Hodgkin's lymphomas (NHL) of Burkitt's or non-Burkitt's type and 3 B cell acute lymphoblastic leukemias were treated with various multiagent chemotherapy regimens containing modest to high dose methotrexate (HDMTX) infusions. All were children between the ages 2 years 8 months and 14 years 1 month. The group included 13 boys and 3 girls. The lymphomas were located primarily in the head and neck, 5; abdomen, 7; and lymph nodes, 1. The clinical stages at diagnosis were stage I, 1; stage II, 6; stage III, 3; and stage IV, 3. The MTX infusion dosage ranged from 300 to 4,285 mg/M2, and the total cumulative dose per patient ranged from 750 to 30,168 mg/M2. Citrovorum Factor Rescue was given following all MTX infusions, except for 62 of the 300 mg/M2 infusions. The serum MTX levels were monitored following all HDMTX. The chemotherapy related toxicities were graded and analysed. The clinical characteristics, which might predispose to HDMTX-related toxicities, were identified and are discussed. Our data reveals the inpatient and interpatient variations in the kinetics of MTX. There were no drug-related deaths, and the overall outcome of the patients was satisfactory. We conclude that MTX infusion continues to play an important role in the current management of childhood B cell malignancies; however, obstacles still remain, especially for those with widespread B cell disease.

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