【摘要】 目的研究高三尖杉酯碱（HHT）治疗慢性粒细胞白血病（CML）的疗效及安全性。方法 12例初诊 CML 患者,HHT 2.5 mg·m^-2·d^-1,静脉滴注维持6 h 以上,持续14～21 d 为1个疗程。有效者每月 HHT 维持治疗,并以外周血中性粒细胞绝对值≥1.0×10⁹/L、血小板≥140×10⁹/L 调整用药时间,一般用药5～14 d。每3个月或3个疗程后复查染色体。6个月后以羟基脲（Hu）维持治疗。结果 12例患者中,7例（58.3%）获血液学完全缓解（CHR）,3个疗程后,总的细胞遗传学反应率50%（3例 CCR,3例 MCR）;另5例（41.7%）在治疗3个月内进入加速期或急变期（4例发生在 HHT 1个疗程后）。12例患者中有6例出现严重骨髓抑制,均发生于 CHR 者。结论 HHT 治疗 CML-CP,可获得较高的血液学和细胞遗传学缓解率,但也可能早期进入加速期或急变期。更多还原

【Abstract】 Objective To investigate the antileukemic efficacy and toxicity of homoharringtonine (HHT)therapy in chronic myelogenous leukemia(CML).Methods Twelve patients with Philadelphia chromo- some positive(Ph~+)CML in chronic phase were treated with a continuous 6 hours infusion of HHT at a daily dose of 2.5 mg/m~2 for 14-21 days.Patients who got hematological remission received maintain therapy for 5- 14 days every month.The number of days could be adjusted according to the absolute granulocyte count and platelet(ANC>≥1.0×10~9/L;PLT≥40×10~9/L).Every 3 cycles or 3 months of HHT treatment,the change of Ph chromosome was determined.After 6 months,the patients were maintained with hydroxyurea.Results Of the 12 patients,7(58.3%)achieved complete hematological remission(CHR).Among the 6 patients(50% of the total patients)who got a cytogenetic response after 3 cycles,3 had completely cytogenetic remission and others have minimal response.Another 5 patients(41.7%)evolved to accelerated or blastic phase earlier in 3 months (4 patients after 1 course of HHT).Conclusion Although CML-CP patients treated with HHT may have high hematological and cytogenetic response,there were a risk of evolving to accelerated or blastic phase earlier.更多还原