CAJ | 학술논문

目的探讨吲哚美辛对干扰素α-2b(IFNα-2b)联合小剂量阿糖胞苷(LD-Ara-C)治疗慢性粒细胞白血病慢性期( CML-CP)患者的影响.方法 22例CML-CP患者按随机数字表法分为2组:对照组10例,用IFNα-2b 300万U,皮下注射,隔日1次,连用3～18个月,Ara-C 30 mg/d缓慢静脉滴注,10d为1个疗程,间歇2周,WBC≥20×109/L时,用羟基脲控制;WBC＜ 20×109/L时停用.治疗组12例,在IFN使用当天增加吲哚美辛25 mg 3次/d,其他治疗与对照组相同.两组均以血液学完全缓解为观察终点,比较两组WBC开始下降时间、WBC降至正常所需时间、外周血幼稚细胞达正常所需时间、达血液学完全缓解所需时间和注射IFN前3d最高体温.结果治疗组和对照组WBC开始下降时间分别为(4.2±2.7)d和(5.0±2.5)d(t=0.714,P＞ 0.05),WBC降至正常所需时间分别为(10.0±4.5)d和(12.0±4.5 )d( t=1.036,P＞0.05);治疗组和对照组外周血幼稚细胞达正常所需时间分别为(14.2±4.8)d和(19.0±3.6)d,差异有统计学意义(t=2.609,P＜0.02);治疗组和对照组达血液学完全缓解所需时间分别为(45.8±5.6)d和( 53.9±10.5)d,治疗组优于对照组(t=2.314,P＜ 0.05).两组注射IFN后发热程度治疗组改善显著优于对照组(x2=12.041,P＜ 0.005).结论吲哚美辛与IFNα-2b联合LD-Ara-C治疗CML-CP,不仅能缓解IFN流感样不良反应而且有协同抗白血病作用.
목적 탐토신타미신대간우소α-2b(IFNα-2b)연합소제량아당포감(LD-Ara-C)치료만성립세포백혈병만성기( CML-CP)환자적영향.방법 22례CML-CP환자안수궤수자표법분위2조:대조조10례,용IFNα-2b 300만U,피하주사,격일1차,련용3～18개월,Ara-C 30 mg/d완만정맥적주,10d위1개료정,간헐2주,WBC≥20×109/L시,용간기뇨공제;WBC＜ 20×109/L시정용.치료조12례,재IFN사용당천증가신타미신25 mg 3차/d,기타치료여대조조상동.량조균이혈액학완전완해위관찰종점,비교량조WBC개시하강시간、WBC강지정상소수시간、외주혈유치세포체정상소수시간、체혈액학완전완해소수시간화주사IFN전3d최고체온.결과 치료조화대조조WBC개시하강시간분별위(4.2±2.7)d화(5.0±2.5)d(t=0.714,P＞ 0.05),WBC강지정상소수시간분별위(10.0±4.5)d화(12.0±4.5 )d( t=1.036,P＞0.05);치료조화대조조외주혈유치세포체정상소수시간분별위(14.2±4.8)d화(19.0±3.6)d,차이유통계학의의(t=2.609,P＜0.02);치료조화대조조체혈액학완전완해소수시간분별위(45.8±5.6)d화( 53.9±10.5)d,치료조우우대조조(t=2.314,P＜ 0.05).량조주사IFN후발열정도치료조개선현저우우대조조(x2=12.041,P＜ 0.005).결론 신타미신여IFNα-2b연합LD-Ara-C치료CML-CP,불부능완해IFN류감양불량반응이차유협동항백혈병작용.
Objective To investigate the influence of indomethacin to the unite treatment effect on chronic phase myeloid leukemia (CML-CP) with interferon alpha-2b (IFNα-2b) and low dose cytarabine (LD-Ara-C).Methods 22 CML-CP patients were randomly divided into two groups.Control groups (10 cases) injected with IFNα-2b (3 million units),injection frequency was q.o.d,the duration of treatment was about 3-18 months,cytarabine (Ara-C) by slowly intravenous driped (30 mg/d).In this treatment schedule,every course of treatment sustained 10 days,and with a 2 weeks interval.During this process,patients in treatment group were treated with hydroxyl urea only when their WBC in peripheral blood exceed 20×109/L,otherwise,discontinue it.Treatment group (12 cases),on the first day of treatment with IFNα-2b and Ara-C,added indomethacin (25 mg) through oral administration,the frequency was t.i.d.During treatment in the two group,the end point of observation was completely hematology ease,at the same time,these indicators in the two groups needed to be compared,the time when WBC begin to fall,the time when WBC fall to normal range,the time when immature cells returned to normal,the time which complete hematological remission and the highest temperature of patients after IFNα-2b was subcutaneous injected.Results The time when WBC begin to fall in treatment group was (4.2±2.7) d,and the time was (5.0±2.5) d in control group (t =0.714,P ＞ 0.05).In treatment group,the time when WBC fall to normal range was(10.0±4.5) d,and the time was (12.0±4.5) d in control group (t =1.036,P ＞ 0.05).The time when immature cells returned to normal in treatment group was (14.2±4.8) d,and the time was (19.0±3.6) d in control group (t =2.609,P ＜ 0.02).The time which complete hematological remission was achieved in control group was (45.8±5.6) d,but it was (53.9±10.5) d in control group (t =2.314,· P ＜ 0.05).Meanwhile,the fever degree after IFNα-2b was subcutaneous injected obviously achieved improvement in treatment group (x2 =12.041,P ＜ 0.005).Conclusion The advantage of indomethacin to the unite treatment with IFNα-2b and LD-Ara-C on CML mainly lays in which cound alleviated the adverse reaction such as flu-like of IFN,and more,there are synergy effect in antagonist CML.