The Observation Of The Therapeutic Effect Of Intermediate-dose Cytarabine For Acute Leukemia

Acute leukemia is a malignancy with the clonal expansion of immature cell.Theincidence rate of adult acute leukemia is 2.76 per 100 thousands.In adult acutemyeloid leukemia complete remission(CR) rates of 60%-70% can be achieved andin adult acute lymphoblastic leukemia is 70-85%.The therapy of AL is including: combination chemotherapy, stem celltranspantation, targeted therapy.Chemotherapy is the most importance of all andchemotherapy is made of remission-induction aand intensive consolidation orpost-remission therapy.In recent years,although chemotherapy can achieve a high rate of diseaseremission induction in patients with AL,patients with recurrent or refractoryAL generally have a poorer rate of response.and more than 50% of them thenrelapse.Part of patients with relapsed or refractory AL who received high-dosecytarabine can achieve CR, and the patients with post-remission can prolong CRtime .The theory is the concentration of cytarabine in plasma would be enhancedby increasing drug`s dose and the therapeutic ara-c levels persisted in thecentral nervous system.So I(H)D-Ara-C provided a sufficient plasma ara-c levelwith a concomitant therapeutic concentration in the cerebrospinal fluid and theycan kill more leukemia wells while the toxicity is tolerable.In an attempt to increase the proportion of patients with ALremaining inlong-term disease-free survival and raise the remission rate of patients withrecurrent or refractory AL. We use intermediate-dose (0.5-1.0g/㎡) cytarabinesingle or combinate other drugs to 80 patients who seeked medical services inour hospital from 1994 to 2005. Results as follows:To post-remission therapy: InAMLpatients,themedianCR durationof theID-Ara-Cgroupandthecontrolgroup who did not receive ID-Ara-C therapy was 9 months(4-24) and 6.5 months(3-19),respectively.There is significant difference between them . In ALLpatients , the median CR duration of the ID-Ara-C group and the control groupwho did not receive ID-Ara-C therapy was 8.5months(4-31) and 4 months(2-19),respectively.There is significant difference between them . The resultshows the ID-Ara-C can prolong the CR duration. In AML patients,the actuarial 1and 2 years DFS was 45% and 8% for ID-Ara-Cgroup versus 20% and less than 1% for the control group.There was significantdifference between them fou one year,but no difference for two years.The resultsare different with other reports.Analysis of the results, we considered oursample was too small and follow-up time was too short,the most important reasonis most of our patients receive ID-Ara-C therapy only for one course,the drug`seffect is not significant . In ALL patients , the actuarial 1yearsDFS was 54.5% for ID-Ara-C groupversus 21.4% for the control group.There was significant difference between...