Chemotherapy of leukemia

By | April 25, 2012

Leukemia chemotherapy, chemotherapy, although the majority of CML patients can and abnormal signs of blood under control, but the median survival (40 months) did not improve. Chemotherapy should pay attention and keep the urine alkaline urine, 2500ml per day or more. Do not cast a glance Ridge plus alcohol 100mg, every 6 / h times, to prevent uric acid nephropathy, white blood cell count to normal after discontinuation of treatment. (1) is the base gland (Hydroxycarbamide, HU): chronic phase CML is the most commonly used chemotherapy drugs and basic treatment, the preferred drug. Are mainly used to reduce the number of high WEC, WEC down when about 20 X 109 / L when the start of imatinib or interferon use. The drug has the advantage of fewer adverse reactions and well tolerated, with no cross-resistance melted agent does not affect the patients after receiving HSCToHU also is not or can not accept imatinib or (and) HSCT chemotherapy drug of choice for patients. (2) Other drugs: Busulfan (Busulfan, BUS, Maryland), Ara-C, Middle School Cephalotaxus lipid base (Ho-moharringtonine, HHT), is Yuhong (Indirubin) ,6-MP, melphalan (melphalan ) ,6-TG, CTX, other chemotherapy agents and the monument is also effective, but only for HU Yuan effect, or with -interferon for MS (such as Ara-C ten interferon; HHT + IFN) and so on. (3) a interferon (Interferon-, IFN-): the drug through the direct inhibition of DNA polymerase activity and interferon regulatory factor CIRF) gene expression, thus affecting the suicide factor (Fas)-mediated apoptosis; by Ph-positive cells increased expression of HLA molecules, is conducive to antigen-presenting cells and T cells to more effectively identify and kill it. Dose of 300-500 million U / (m2 d), subcutaneous or intramuscular injection, 3-7 times per week, continuing to use a few months to several years. Often be reduced by HU excessive white blood cells. 50% of IFN- can be -70% of patients with hematological complete remission (HCR); 10% -26% of patients may be the major cytogenetic remission (MCCR, refers to the bone marrow Ph-positive cells <35%), but the BCR / ABL fusion gene mRNA is still positive, was MCR prolonged survival. Common adverse events were chills, fever, fatigue, nausea, head, muscle and bone pain times. Before the injection and use of acetyl amino hope, reduce the side effects of diphenhydramine, etc., there are still some patients (about 25%) could not tolerate the withdrawal. Combination with Ara-C (monthly Ara-C10-15 mg / (m2.d) used in conjunction 10d) may improve the outcome, the HCR, MCR, and complete cytogenetic remission (CCR, Ph-positive cells as 0) were 67 %, 27% and 7%. Organ dysfunction, but low grade disease. CLL cell morphology similar to mature cells, but immature immune, dysfunction of the cells. Most originated in CLL B cells, T cells are derived from rare.Leukemia chemotherapy, the disease is more common in Europe and the United States, but in China, Japan and Southeast Asian countries is less common.

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