- 期刊
以低劑量Ara-C治療急性非淋巴球性白血病之骨髓變化─療效機轉之探討
Bone Marrow Changes in Acute Non-Lymphocytic Leukemia Patients Treated with Low-Dose Ara-C - Implications of Therapeutic Mechanism
摘要
12位以低劑量Ara-C治療得到反應的急性非淋巴球性白血病病人，其中有4位為完全緩解，8位為部份緩解，在低劑量Ara-C給予前及投予一週期（14-21天）後施行骨髓抽吸及骨髓生檢的檢查，分析觀察治療前後骨髓之變化，可得到如下的壯果：(A)4位病人經治療後，骨髓內有明顯成熟細胞之出現，由治療前平均10.6%增為46.8%，而其骨髓內cellularity 之減少平均為10%(B)8位病人經治療後，骨髓內無明顯的成熟細胞出現，代之為漿細胞及淋巴球之浸潤，且骨髓內cellularity之減少平均為32%。由此結果可顯示低劑量Ara-C在急性非淋巴球性白血病之治療效果經由兩種機轉(一)為誘導細胞分化之作用如(A)組病人經治療後有明顯成熟細胞出現者。(二)為細胞毒殺之作用如(B)組病人經治療後無明顯成熟細胞出現，但骨髓內cellularity則有明顯減少之情形。至於在其治療中作用機轉之選擇則因病例而異，預測方法仍未知。
關鍵字
無資料並列摘要
Twelve acute non-lymphocytic leukemia patients were treated with low-dose Ara-C with good response. Four patients achieved complete remission and eight partial remission. Bone marrow aspiration and biopsy were performed before and after treatment with one cycle of low-dose Ara-C (14 days to 21 days). By analyzing the change of the bone marrow constituents, we obtained the following results: (A) The mature myeloid cells increased after treatment in four patients. The proportion of mature cells increased from 10.6% before treatment to 46.8% after one cycle of low-dose Ara-C. The cellularity of bone marrow decreased only 10% in these four patients. (B) No prominent mature cells were found after treatment in the other eight patients. The mature cells were replaced by lymphoytes and plasma cells. The cellularity of bone marrow decreased 32% in these patients. The results suggest two kinds of mechanism in the therapeutic effects of low-dose Ara-C. One is the induction of differentiation found in group (A) patients. More mature cells appeared after low-dose Ara-C. Another is the direct cytotoxic effect found in group (B) patients. No prominent mature cells appeared after treatment while the cellularity of bone marrow decreased markedly. The predictive application of low-dose Ara-C for therapy in acute non-lymphocytic leukemia has not yet been established.
延伸閱讀
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