Leukemia Treatment

By | April 24, 2012

Leukemia treatment, 1. Chemical drugs
Can only improve the symptoms and signs, but not prolong survival and cure the disease.
(1) single-agent chlorambucil: 4,8 mg / (m2 d), qd for 4, and 8 weeks, adjust dose according to blood to prevent excessive bone marrow suppression; also stopped medication: 0.4,0.7 mg / candle, 1d oral or sub-4d, and then bone marrow recovery, every 2,4 weeks for a cycle.
(2) single drug Fludarabine: 25,30 mg / (m2 d), continuous 5d intravenous infusion, repeated every 4 weeks.
(3) Other glanced Ridge drugs: such as cladribine (cladribine, 2-CdA) and spray ulinastatin (Pentosta-tine, DCF). Melted plastic agents such as cyclic, COP or CHOP (see first section). Burnt agents who switch to Fludarabine resistance still effective.
(4) Fludarabine and cyclic plastic joint (FC): is the treatment of relapsed refractory CLL effective program.
Leukemia treatment, 2. Complication of treatment
CLL patients with normal immune globulin reduce neutropenia, vulnerable to infection, which is the main cause of death in CLL. Should be actively prevent infection. Repeated infection may intravenous immunoglobulin. Concurrent autoimmune hemolytic anemia or thrombocytopenic purpura epilepsy who used corticosteroids. If invalid splenomegaly may consider splenectomy significantly after surgery red blood cells, platelets may be picked up, but little change in blood lymphocytes.
3. Immunotherapy
Monoclonal antibody to group A (Campath-1H) is a humanized mouse anti-human CD52 monoclonal antibody, were almost all CLL cells express CD520Campath-1H to 1 / 3 of Fludarabine in patients with resistant CLL effective, radical P53 mutation or deletion of CLL, but the high tumor burden in patients with poor effect of lymph node enlargement. The antibodies can remove the blood and bone marrow CLL cells, ideal for maintenance therapy. Usage: The initial dose of intravenous infusion 3mg / d, gradually increased to a daily 20-30mg, 2-3 times per week, a total of 4,6 weeks, may be given before the infusion of methylprednisolone. The main side effects are bone marrow suppression and immune suppression caused by infection, bleeding and anemia, and serum sickness-like reaction. Rituximab far less effect on the CLL B-cell NHL, because CLL cells express CD20 antigen is low, required before high-dose rituximab may be effective. Rituximab in combination with chemotherapy drugs, but also for drugs used to treat CLL Ridge winded minimal residual disease clearance. Order to facilitate the proper use of celecoxib 375mg / (m2 W) x4 times when the intravenous drip = initial dose, 50mg / h infusion, and then increased 50mg per hour until the 375mg/m20 rituximab compared with the Campath-IH, bone marrow immune suppression and the potential inhibition of both weak. The main adverse events were allergic reactions.
Leukemia treatment, 4. Hematopoietic stem cell transplantation
In remission, the use of autologous stem cell transplantation for treatment of CLL obtain satisfactory results, patients with minimal residual disease in vivo can be negative, but follow-up to 4 years about 50% of the recurrence. Allogeneic stem cell transplantation for treatment of CLL, make long-term survival in some patients to be cured. However, many patients> 50 years of age; conventional transplant program-related toxicity, complications, in recent years to adopt a Fludarabine-based non-myeloablative hematopoietic stem cell transplantation (NST), reduced the transplant-related mortality risk is expected to slow healing leaching.

Leave a Reply

Your email address will not be published. Required fields are marked *