目的 探讨改良VDLP方案治疗老年急性淋巴细胞白血病(ALL)的效果及不良反应。方法 将2009年1月1日至2014年12月31日来该院就诊的初诊老年ALL患者随机分成实验组和对照组,对照组诱导化疗采取传统的VDLP方案(长春新碱2 mg,第1、8、15天;DNR 30-40 mg/m^2,第1-3天,第15-16天;左旋门冬酰胺6 000-10 000 U,第11、14、17、20天;泼尼松1 mg/kg,第1-14天,继之减量,1-2 w减停);实验组诱导化疗采取改良VDLP方案诱导治疗(长春新碱2 mg,第1、8、15天;DNR 30 mg-40 mg/m^2,第1-3天;左旋门冬酰胺酶6 000-10 000 U,第11、14、17、20天;泼尼松1 mg/kg,第1-14天,继之减量,1-2 w减停)。观察两组患者的缓解率及并发症。结果 实验组与对照组CR率无统计学差异(P〉0.05),治疗相关死亡率、重症感染发生率有统计学差异(P〈0.05)。结论 改良VDLP方案与传统VDLP方案相比有更好的耐受性,更适合老年ALL的诱导化疗。
Objective To investigate the efficacy and toxicity of modified VDLP and VDLP on patients over 55 years with acute lym- phoblastic leukemia(ALL). Methods 31 patients over 55 years with ALL were divided into modified VDLP or VDLP groups. Results The complete response(CR) rate was 53.3% in modified VDLP group, which had no significant difference compared with that of VDLP group (58.3%) (P〉0.05). The main toxicities of the two groups were infection. The infection rate of modified VDLP group( 31.3% )was lower than that of VDLP group(66.7% ). Conclusions Modified VDLP is effective for patients over 55 years with ALL. Modified VDLP has low adverse reactions and could be individualized to elder patients.