564 1002-0217 2015 06-0564 - 04 HTA 241001 HHT THP Ara-C HTA AML 2006 8 ~ 2013 12 15 AML HTA 1 CR + CRi PR OR CR + PR DA 23 HTA 15 1 CR 11 PR 2 OR 13 DA 23 1 CR 14 PR 3 OR 17 HTA CR DA P > 0. 05 HTA AML R 733. 71 A DOI 10. 3969 / j. issn. 1002-0217. 2015. 06. 016 Efficacies of HTA regimen for acute myeloid leukemia WEI Zhongling SU Guiping Department of Hematology The first Affiliated Hospital of Wannan Medical College Wuhu 241001 China Abstract Objective To evaluate the efficacy and adverse events of induction chemotherapy by combined regimen of homoharringtonine pirarubicin and cytarabine HTA for initially diagnosed acute myeloid leukemia AML. Methods The efficacies and adverse responses were retrospectively examined in 15 cases of AML treated with HTA regimen in our department between August 2006 and December 2013. The rates of complete remission CR partial remission PR and overall remission OR in one course of chemotherapy induction were summed up and compared with another group of patients controls n = 23 received dose-adjusted DA regimen. Results CR PR and OR were identified in 11 cases in 2 cases and in 13 cases in HTA group compared to 14 cases 3 cases and 17 cases respectively in DA group. Although HTA group had slightly higher CR than DA group yet the difference was not significant P > 0. 05. Conclusion HTA may be served as one of the regimens in induction chemotherapy for AML for the adverse reactions can be tolerated. Key words leukemia cytarabine homoharringtonine pirarubicin acute myeloid leukemia AML 1 DNR Ara-C 1. 1 2006 8 ~ 2013 1 12 HTA 15 CR 50% ~ 60% 2 DNR CR 3-4 DNR AML 5 1 AML FAB M3 2 HHT THP Ara-C HTA 3 2014 AML15 DA 23 3 AML2004 3 ~ 2014 2 DA 23 2015-01-01 1979-13965181847 liuwu66@ sohu. com yjssuguiping@ sohu. com.
565 1. 2 HTA NR ORRCR + PR HHT 2 ~ 3 mg /d 5 ~ 7 d THP 10 ~ 20 mg / d 2 ~ 3 d Ara-C 100 ~ 150 mg / m 2 d 5 ~ 7 d DA DNR 40 ~ 60 mg / m 2 d 1 ~ 3 d Ara-C 100 ~ 150 mg / m 2 d 5 ~ 7 d 1. 3 1. 6 SPSS 16. 0 3% ± 1 5000 t Fisher P 100 10 9 /L < 0. 05 36 h < 60 g /L 2 < 20 10 9 /L 2. 1 HTA 9 6 18 ~ 59 43. 1 ± 14. 7FAB 38. 3 2 38 1 h 10 9 /L 36 ~ 126 g /L 5 ~ 135 10 9 /L 27 ~ 93 % 2 11 2 DA 7 16 15 ~ 59 42. 3 ± 1. 4 10. 9FAB M1 4 M2 16 M4 1 1 M5 2 0. 8 ~ 203. 6 2 ~ 3 1 1 37 ~ 109 g /L 8 ~ 252 3 20 ~ 97 % 0 WHO 0 ~ Ⅳ < 20 10 9 /L M1 3 M2 12 1. 3 ~ 127 20 3 1. 5 FAB 5 CR CR CRi PR P > 0. 05 1 1 M1 M2 M4 M5 g /L HTA 43. 1 ± 14. 7 9 6 3 12 0 0 29. 11 ± 39. 73 62. 87 ± 23. 17 59. 67 ± 44. 11 55. 27 ± 18. 94 DA 42. 3 ± 10. 9 7 16 4 16 1 2 25. 75 ± 42. 88 66. 08 ± 21. 61 53. 17 ± 47. 07 58. 19 ± 21. 92 t 0. 202 - - 0. 243 0. 437 0. 426 0. 424 P 0. 841 0. 099 1. 000 0. 809 0. 665 0. 763 0. 674 2. 2 HTA 15 1 P > 0. 05 Fisher CR 11 PR 2 NR 2 OR 13 2 11 2 1 CR 2 /2 8 /11 1 /2 DA 23 1 CR 14 PR 3 NR 6 OR 17 20 3 1 CR 13 /20 1 /3 P = 0. 501 2 2 % CR PR NR OR HTA 11 2 2 13 DA 14 3 6 17
566 2. 3 2. 3. 1 38 P < 0. 05 20 10 9 /L WHO 3 Ⅲ ~ Ⅳ HTA DA HTA DA 3 d 20 10 9 /L d HTA 0. 55 ± 0. 24 14. 20 ± 9. 17 9. 60 ± 9. 58 10. 3 ± 8. 39 6. 93 ± 2. 31 2. 79 ± 1. 87 DA 0. 70 ± 0. 39 7. 13 ± 5. 23 17. 69 ± 13. 06 11. 0 ± 7. 63 7. 30 ± 3. 40 2. 93 ± 1. 56 t 1. 297 3. 209 2. 062 0. 270 0. 369 0. 256 P 0. 203 0. 005 0. 046 0. 879 0. 714 0. 799 2. 3. 2 HTA 1 Ⅰ DA HTA Fisher P > 0. 05 4 U 4 HTA 11 2 0 14 13 7 DA 14 3 2 23 23 15 P 0. 501 0. 628 0. 505 0. 395 0. 378 0. 258 2. 4 HTA 15 4 ~ 80 8 7 CR 18 95% CI 14. 28 ~ 21. 72 DA 21 2 1 ~ 120 8 13 16 95% CI 13. 18 ~ 18. 82 DA 1 OS 60. 87% HTA 1 OS 80. 0% P = 0. 294 1 1 3 DA 50% ~ 60% DNR DNR DNA α β DNA G2 6 7 TA DA THP 900 ~ 1100 mg /m 2 DNR 550 mg /m 2 8-9 CR 10-11 AML AML HHT
567 G1 G2 S HHT DNR DNA THP 12 THP HHT Ara-C HA DA 30% 18 HTA HA DA DA HHT DNR 13 HAD HTA 1 OS AML CR 65. 7% 15 236 AML HTA HAA CR 65. 7% CR 78% 16 HAA HAD DA HTA HAA HAD DA CR 73% 67% 61% HAA HAD DA HTA AML CR 11 /15 DA 14 /23 3-4 HTA DA HTA DA HTA DA 13 /15 vs 23 /23 HTA DA 20 10 9 /L 20 10 9 /L 2008 28 6 532-534. 8 Fazlina N Maha A Jamal R HHT 2. 5 mg / m 2 d1 17 et al. Prognostic value of immunophenotyping in elderly patients with acute myeloid leukemia a sin- 112 3 572-580. 9 Plesa C Chelghoum Y Plesa A gle-institution experience J. Cancer 2008 DA 78. 6% 14 CR HTA HTA AML 1. 2011 J. 2011 32 11 804-807. 2 Berman E Heller G Santorsa J et al. 1991 Results of a randomized trial comparing idarubicin and cytosine arabinoside with daunorubicin and cytosine arabinoside in adult patients with newly diagnosed acute myelogenous leukemia J. Blood 1991 77 8 1666-1674. 3 Lee JH Joo YD Kim H et al. A randomized trial comparing standard versus high-dose daunorubicin induction in patients with acute myeloid leukemia J. Blood 2011 118 14 3832-3841. 4 Fernandez HF Sun z Yao X et al. Anthracycline dose intensification in acute myeloid leukemia J. N EnglJ Med 2009 361 1249-1259. 5. M. 2. 1998 171-183. 6 Isuruo T Iidah Tsukagoshi S et al. 4'-O-tetrahydropyranyladriameycin as a potential new antitumor agent J. Cancer Res 1982 42 4 1462-1467. 7. J. et al. Expression of multidrug resistance MDR proteins and in vitro drug resistance in acute leukemias J. Hematology 2007 12 1 33-37.
568 1002-0217 2015 06-0568 - 03 1 2 1 1 1 2 1. 052360 2. 050000 BACTEC MGIT 960 30 BACTEC MGIT 960 13. 3% 4 /30 3. 33% 1 /30 56. 7% 17 /30 BACTEC MGIT 960 P < 0. 005 BACTEC MGIT960 R 725. 1 A DOI 10. 3969 / j. issn. 1002-0217. 2015. 06. 017 Diagnosis of tuberculous meningitis in children by modified Ziehl-Neelsen stain CAO Xiaona SHAO Yanxin GAO Qing SU Yi WEI Yuan FENG Jianchun Department of Pediatrics The First People's Hospital of Xinji City Xinji 052360 China Abstract Objective To assess the clinical value of applying modified Ziehl-Neelsen stain to diagnosis of tuberculous meningitis in children. Methods The cerebrospinal fluid CSF was detected in 30 cases confirmed clinically as tuberculous meningitis by BACTEC MGIT 960 culture system centrifuged smear test and modified Ziehl-Neelsen stain respectively and the results were compared for the positive accuracy. Results The positive rate by BACTEC MGIT 960 culture system centrifuged smear test and modified Ziehl-Neelsen stain was 13. 3% 4 /30 3. 33% 1 /30 and 56. 7% 17 /30 respective- ly and the difference was significant P < 0. 005. Conclusion The modified Ziehl-Neelsen stain can be more sensitive in rapid diagnosis of tuberculous meningitis in children and is worthy of wider clinical recommendation. Key words cerebrospinal fluid modified Ziehl-Neelsen stain BACTEC MGIT 960 culture system Mycobacterium tuberculosis 2015-05-03 1981-15633037060 jj_jyj@ 163. com 68752145@ qq. com. 10 Harvey P Roger B D Jeffrey K et al. Comparison of three remisson 11 767-768. in duction regimens and two postinduction strategies for the treat- 15. HAA ment of acute nonlymphocytic leukemia a cancer and leukemia 236 J. 2013 34 group B study J. Blood 1987 69 5 1441-1449. 10 825-829. 11. 16 Jin JI Wang JX Chen FF et al. Homoharringtonine-based induction regimens for patients with de-novo acute myeloid leukaemia a 12. 61 multicentre open-label randomised controlled phase 3 trial J. 91 J. 1990 29 1 22-25. HA DA J. 1992 5 1 Lancet Oncol 2013 14 7 599-608. 1-4. 17 O'Brien S Kantarjian H Keadng M et al. Homoharringtoalne ther- 13. HA apy induces responses in patients chronic myelogenous Leukemia in J. late chronic phase J. Blood 1995 86 9 3322-3332. 2005 12 26 705-709. 14. DEA DHA J. 2010 31 18 Zhong LY Li QH Huang ZL et al. Regimen containing perarubicin for the treatment of newly diagnosed young patients with acute myeloid leukemia J. Ai Zheng 2009 28 6 619-625.