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fludarabine and cytarabine combined chemotherapy followed by transfusion of donor blood stem cells for treating relapse of acute leukaemia after allogeneic haematopoietic stem cell transplantation

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Chinese Medical Journal 2008年第18期121卷 1770-1774页

作者： YOU Yong LI Qiu-bai CHEN Zhi-chao LI Wei-ming XIA Ling-hui ZHOU Hao ZOU Ping Institute of Haematology Union Hospital Tongji Medical College of Huazhong University of Science and Technology WuhanHubei 430022 China

Background Relapse remains an obstacle to successful allogeneic haematopoietic stem cell transplantation （allo-HSCT） for patients with acute leukaemia and no standard treatment is available. We assessed fludarabine and cytarabine with transfusion of donor haematopoietic stem cell in treating the relapse of acute leukaemia after allo-HSCT. Methods Seven patients, median age 34 years, with relapse of acute leukaemia after allo-HSCT received combination chemotherapy of fludarabine with cytarabine for 5 days. Five patients suffered from acute myeloid leukaemia （2 refractory） and 2 refractory acute lymphoblastic leukaemia. After the transplantation, the median relapse time was 110 days （range, 38-185 days）. Two days after chemotherapy, 5 patients received infusion of donor＇s peripheral blood stem cells, mobilized by granulocyte colony stimulating factor. No prophylactic agents of graft versus host diseases were administered, Results Six patients achieved haematopoietic reconstitution. DNA sequence analysis at day 30 after treatment identified all as full donor chimera type. The median observation time was 189 days. After the treatment, the median time for neutrophilic granulocyte value 〉0.5×10^9/L and for platelet value 〉20×10^9/L were 13 days （range, 10-18 days） and 15 days （range, 11-24 days）, respectively. Graft versus host disease occurred in 2 patients （acute） and 3 （chronic）. Five patients suffered from pulmonary fungal infection （2 died）, 3 haemorrhagic cystitis and 2 cytomegalovirus viraemia. The other patients died of leukaemia related deaths. Three patients with chronic graft versus host disease who had received donor peripheral blood stem cells reinfusion have survived for 375 days, 232 days and 195 days, respectively. Conclusions fludarabine with cytarabine plus the donor haematopoietic stem cell should be considered as an effective therapeutic regimen for relapse of acute leukaemia after alIo-HSCT. The disease free state of patients may increase, though with

关键词： fludarabine allogeneic haematopoietic stem cell transplantation relapse acute leukaemia

Clinical Observation of FMD Regimen:fludarabine,Mitoxantrone,Dexamethasone,in Treatment of Non-Hodgkin's Lymphoma

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Chinese Journal of Clinical Oncology 2008年第6期5卷 433-436页

作者： Shuqing Lu Jianmin Wang Xianmin Song Li Chen Weiping Zhang Jun Hou Xiaoqian Xu Chongmei Huang Jianmin Yang Department of Hematology Changhai Hospital Second Military Medical UniversityShanghai 200433 China

OBJECTIVE To evaluate the clinical effectivity and toxicity of the regimen FMD （fludarabine, mitoxantrone, dexamethasone） in patients with non-Hodgkin＇s lymphoma. METHODS Thirty-two patients, twenty-four of whom had indolent B-cell lymphoma, 6 peripheral T-cell lymphoma, two diffuse large B-cell lymphoma, received FMD. Treatment comprised： fludarabine 25-30 mg/m^2 days 1-3, mitoxantrone 8-10 mg/m^2 day 1, and dexamethasone 20-30 mg/m^2 days 1-5. At the same time, patients received prophylaxis against conditional infection with trimethoprim-sulfamethoxazole, fluconazole, acyclovir and immunoglobulin. RESULTS Of the thirty-two patients treated, the complete response （CR） rate, partial response （PR） rate and overall response （OR） rate were 56.3%, 21.9% and 78.2% respectively. The CR and OR rate of 24 patients with indolent B-cell lymphoma were 66.7% and 88.3% respectively. Two of six patients with peripheral T-cell lymphoma were of complete response type and one was of partial response type. One of two patients with diffuse large B-cell lymphoma was partial response. The dominating toxicity was myelotoxicity and immunotoxicity. There was no treatment associated death in all patients treated with FMD. Grade 3-4 neutropenia occurred in 43.8% patients, 12.5% patients had infections and 9.3% developed grade 3-4 thrombocytopenia. At a median follow-up of 24 （5-54） months, the 2-year overall-survival rate and progression-free survival rate were （87.5 ± 1.4）% and （83.3 ± 1.6）% respectively. The 2-year OS and PFS rates of the indolent group were （93.75 ± 6.25）% and （87.5 ± 8.54）%. CONCLUSION FMD regimen was highly effective with low toxicity in the treatment of non-Hodgkin＇s lymphoma, especially in indolent B-cell lymphoma. It also helps to improve the prognosis even in some aggressive lymphoma, such as peripheral T cell lymphoma.

关键词： fludarabine mitoxantrone dexamethasone lymphoma non-Hodgkin's.

fludarabine—一种新药治疗幼淋和慢淋幼稚变的效果

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国际输血及血液学杂志 1991年第6期 401-402页

作者：伍建中

本文作者观察了fludarabine（FDB）(一种新的腺嘌呤核苷酸类似物)治疗幼稚淋巴细胞白血病（PLL）和慢性淋巴细胞白血病幼稚变（CLL-Pro）的效果。本组病人17例,男11例,女6例;年龄48～86岁,平均64岁。临床诊断根据病史、临床症状、体征... 详细信息

本文作者观察了fludarabine（FDB）(一种新的腺嘌呤核苷酸类似物)治疗幼稚淋巴细胞白血病（PLL）和慢性淋巴细胞白血病幼稚变（CLL-Pro）的效果。本组病人17例,男11例,女6例;年龄48～86岁,平均64岁。临床诊断根据病史、临床症状、体征（如脾严重肿大）和实验室检查（如诊断PLL要求骨髓中幼稚淋巴细胞≥30％,CLL-Pro骨髓中的幼稚淋巴细胞在10～29％之间）,而最后确诊。本文17例,12例单用FDB,按30mg/m;/日计,一次超过30分钟,连续5天/4周;另5例增用强的松,按60mg/m;/日计,连续用5天。绝大多数（15例）治疗2个疗程,治疗无效的平均治疗时间3个月。17例的临床疗效为:3例完全缓解（18％）,3例部分缓解

关键词：淋巴细胞骨髓 PLL FDB Pr 白细胞造血系统 fludarabine

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fludarabine的临床应用

国外医学（肿瘤学分册） 1998年第2期25卷 116-118页

作者：胡炯仇倩瑶上海第二医科大学附属瑞金医院 200025

fludarabine(FDB)是近年来发展的新型抗肿瘤药物,在血液系统恶性肿瘤,尤其是淋巴系统恶性疾病,如慢性淋巴细胞性白血病(CLL)、淋巴瘤(lymphoma)治疗中有广泛应用。FDB不仅可以作为单药化疗,而且可以联合其它化疗药物治疗低度恶性NHL(LG... 详细信息

fludarabine(FDB)是近年来发展的新型抗肿瘤药物,在血液系统恶性肿瘤,尤其是淋巴系统恶性疾病,如慢性淋巴细胞性白血病(CLL)、淋巴瘤(lymphoma)治疗中有广泛应用。FDB不仅可以作为单药化疗,而且可以联合其它化疗药物治疗低度恶性NHL(LGL),提高疗效;并且还可应用于AML/MDS等髓系恶性疾病的治疗。

关键词： fludarabine 淋巴瘤慢性淋巴细胞性白血病

Remission of Relapsing Immunotactoid Glomerulonephritis with fludarabine

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Open Journal of Nephrology 2013年第1期3卷 41-43页

作者： Suchita J. Mehta Majed M. Samarneh Militza K. Kiroycheva Michael B. Stokes John M. Pepe Department of Medicine Staten Island University Hospital New York USA. Division of Nephrology Staten Island University Hospital New York USA. Division of Renal Pathology Department of Pathology and Cell Biology Columbia University Medical Center New York Presbyterian Hospital New York USA

Immunotactoid gloemrulonephritis is a glomerular disease characterized by organized microtubular deposits of monoclonal immunoglobulin. These deposits are Congo red-negative, have hollow centers, measure > 30 nm, and are arranged in stacked or parallel arrays. Treatment of immunotactoid glomerulonephritis is not well-defined, with poor outcomes seen in native kidneys. In fewer than 10% of the cases, trials with steroids alone or cytotoxic agents with steroids or plasmapheresis with steroids has been associated with clinical remission of proteinuria. 50% of patients with renal impairment progress to end stage renal disease (ESRD) in two to four years. There are three case reports of recurrent ITG in renal allograft;one was treated with pulse steroids plus cyclophosphamide, pulse steroids in second case and use of rituximab in the third case. Recurrence of ITG has been described in the renal allograft but there is no literature on relapse of ITG in the native kidneys. Here, we have a case of ITG that relapsed in the native kidneys eight years after being in remission. Renal function improved with fludarabine both times and the patient had stable renal function at last follow-up.

关键词： Glomerulonephritis fludarabine ITGN

应用fludarabine治疗毛细胞白血病

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国际肿瘤学杂志 1991年第5期30卷 318-319页

作者：叶欣沈绍华

毛细胞白血病(HCL)是一种以浸润骨髓、肝、脾为主引起全血细胞减少、脾大及各种免疫低下为特征的慢性B淋巴细胞增生性疾病。脾切除是治疗本病的主要手段,临床有效率为75％。α-干扰素、2-去氧助间型霉素(DCF)和-2氯脱氧腺苷也可治疗HCL,... 详细信息

毛细胞白血病(HCL)是一种以浸润骨髓、肝、脾为主引起全血细胞减少、脾大及各种免疫低下为特征的慢性B淋巴细胞增生性疾病。脾切除是治疗本病的主要手段,临床有效率为75％。α-干扰素、2-去氧助间型霉素(DCF)和-2氯脱氧腺苷也可治疗HCL,DCFα-干扰素治疗耐药的HCL仍然有效,变异型的HCL(HCL-V)对一般治疗效果较差。 fludarabine是一种腺嘌呤核苷的类似物,其结构与DCF和2-氯脱氧腺苷相似,能抑制腺苷脱氨酶的活性。

关键词：毛细胞白血病 fludarabine 慢淋 α-干扰素全血细胞减少免疫低下间型霉素脱氧腺苷淋巴瘤腺苷脱氨酶

fludarabine治疗毛细胞白血病(HCL)

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国际输血及血液学杂志 1992年第1期 49-49页

作者：刁兰萍

fludarabine 是一种新型腺嘌呤核苷类药物。作者首次报导了用其治疗3例HCL。计男2例,女1例。年龄分别为33、40及69岁。前2例为典型的HCL,例3为其变异型。后者的诊断系依据在光镜与电镜下于骨髓及脾脏中发现非典型淋巴样细胞,该细胞较典... 详细信息

fludarabine 是一种新型腺嘌呤核苷类药物。作者首次报导了用其治疗3例HCL。计男2例,女1例。年龄分别为33、40及69岁。前2例为典型的HCL,例3为其变异型。后者的诊断系依据在光镜与电镜下于骨髓及脾脏中发现非典型淋巴样细胞,该细胞较典型之毛细胞为大,抗酒石酸磷酸酶(TRAP)染色阳性者fludarabine 治疗前均曾用α-干扰素,例2、3曾经切脾治疗,例2还用过强的松及2′-去氧助间型霉素(DCF)。

关键词：毛细胞疗程 fludarabine HCL

慢性淋巴细胞白血病患者fludarabine相关的自身免疫性溶血性贫血

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国际输血及血液学杂志 1996年第4期 241-241页

作者：姚仁南

52例慢性淋巴细胞白血病（CLL）患者用fludarabine治疗,25mg/m;,静脉滴注,每天1次,共5天。同期用fludarabine治疗了18例其他类型的慢性淋巴细胞增殖性疾病。CLL按Binet法分期。AIHA按标准的方法诊断:血红蛋白降低伴球形红细胞、网织红... 详细信息

52例慢性淋巴细胞白血病（CLL）患者用fludarabine治疗,25mg/m;,静脉滴注,每天1次,共5天。同期用fludarabine治疗了18例其他类型的慢性淋巴细胞增殖性疾病。CLL按Binet法分期。AIHA按标准的方法诊断:血红蛋白降低伴球形红细胞、网织红细胞增多,尿胆素原增高。直接抗人球蛋白试验（DAT）阳性。在fludarabine治疗后,12例患者（男性7例,女性5例,平均年龄59岁,范围49～81岁）产生温抗体型AIHA,占用该法治疗患者的21％。所有患者有B期或C期疾病,在治疗时有高的白细胞计数。因预先血小板减少,3例患者fludarabine剂量减半。9/12例患者既往无

关键词：慢性淋巴细胞白血病 AIHA fludarabine 慢性淋巴细胞增殖性疾病患者

Analyses of therapeutic effects using rludarabine and cytarabine on acute myeloid leukemia at different stages during treatment

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The Chinese-German Journal of Clinical Oncology 2009年第6期8卷 349-352页

作者： Na Xu Xiaoli Liu Qjngfeng Du Lingyun Ouyang Zhi Liu Lijun Hou Department of Hematology Nanfang Hospital Southern Medical University Guangzhou 510515 China Department of Hematology and Rheumatisis The Fifth Affiliated Hospital Sun Yat-sen University Zhuhai 519000 China

Objective: To evaluate the therapeutic effect of the fludarabine and cytarabine (FA) regimen on acute myeloid leukemia (AML) at different phases during treatment. Methods: A total of 185 patients with AML were divided into 4 groups based on the outcome of previous treatments. Patients in Group 1 had no remission after the first course of induction chemotherapy (n = 55). Patients in Group 2 had no remission after no less than two courses of induction chemotherapy (n = 41). Patients in Group 3 had early relapse (n = 40). Patients in Group 4 had late relapse (n = 49). Patients in groups 2, 3 and 4 had refractory AML or AML with relapse. We assessed the efficacy and toxicity of FA combination chemotherapy in each of these 4 groups. Results: The complete remission (CR) rates of Groups 1, 2, 3 and 4 were 74.5% (41/55), 45.9% (19/41), 17.5% (7/40) and 38.8% (19/49), respectively. The CR rate was higher in Group 1 than in the other 3 groups (34.6%, 45/130) (P = 0.000). A significant correlation was found between CR rate and the number of chemotherapeutic courses (P = 0.023). The main adverse reactions included bone marrow suppression and secondary infection. Conclusion: FA regimen is a good choice for patients with AML, especially those who have failed to achieve CR after the first course of induction chemotherapy.

关键词： acute myeloid leukemia (AML) fludarabine cytarabine