Deoxycoformycin treatment for childhood T-cell acute lymphoblastic leukemia early in second remission: a Pediatric Oncology Group Study.
Deoxycoformycin treatment for childhood T-cell acute lymphoblastic leukemia early in second remission: a Pediatric Oncology Group Study.
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脱氧考福霉素治疗第二次缓解早期儿童 T 细胞急性淋巴细胞白血病：一项儿科肿瘤学小组研究。
DOI：
10.1002/mpo.2950160507
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
Boyett,J
中科院分区：
文献类型：
--
作者：
Winick,N;Buchanan,GR;Murphy,SB;Yu,A;Boyett,J
2-脱氧考福霉素 (DCF) 被添加到儿科肿瘤小组强化方案 (8303) 中，用于治疗 T 细胞急性淋巴细胞白血病或首次复发的 T 细胞淋巴母细胞淋巴瘤儿童。 27 名患者在通过四种药物再诱导方案获得第二次缓解后立即接受了一个或多个疗程的 DCF，剂量为 15 mg/m2/天，为期 3 天的连续输注。尽管在 DCF 输注后 1 天通过浓缩红细胞输注提供了腺苷脱氨酶来源，但肾脏和神经肌肉毒性仍然频繁发生，有时甚至很严重。 62% 的疗程均伴有肝毒性，表现为转氨酶升高。第二次完全缓解的中位持续时间为 4 个月（范围为 2‐16+ 个月），27 名患者中只有两人在 13+ 和 16+ 个月时仍处于缓解状态。在 DCF 输注之前和第 4 天测量脱氧腺苷 (dAdo) 的血浆浓度以及红细胞三磷酸脱氧腺苷与三磷酸腺苷 (dATP:ATP) 的比率。在两名急性肾功能衰竭患者中发现 dATP:ATP 比率为 1.0 或更高。毒性或反应与血浆 dAdo 浓度之间没有明显的相关性。根据该剂量和时间表施用的 DCF 毒性太大，并且没有明显延长 T 细胞淋巴母细胞恶性肿瘤儿童第二次完全缓解的持续时间。
2‐Deoxycoformycin (DCF) was added to an intensive Pediatric Oncology Group protocol ( 8303) for children with T‐cell acute lymphoblastic leukemia or T‐cell lymphoblastic lymphoma in first relapse. Twenty‐seven patients received one or more courses of DCF at 15 mg/m2/day as a 3‐day continuous infusion immediately after achieving a second remission with a four‐drug reinduction regimen. Renal and neuromuscular toxicities were frequent and occasionally severe despite the provision of a source of adenosine deaminase by means of a packed red cell transfusion 1 day following the infusion of DCF. Hepatic toxicity, manifested by transaminase elevations, accompanied 62% of the courses. The median duration of the second complete re mission was 4 months (range 2‐16+ months) with only two of the 27 patients still in remission at 13 + and 16 + months. Plasma concentrations of deoxyadenosine (dAdo) and the ratio of red cell deoxyadenosine triphosphate to adenosine triphosphate (dATP:ATP) were measured prior to the DCF infusion and on day 4. A dATP:ATP ratio of 1.0 or greater was seen in two patients with acute renal failure. There was no apparent correlation between toxicity or response and the plasma dAdo concentrations. DCF administered according to this dose and schedule was excessively toxic and did not appreciably prolong the duration of the second complete remission in children with T‐cell lymphoblastic malignancies.