06.09 白血病.pptVIP

* xie Yi,Hua Shan Hospital * 1，Regimen induced remission （1）for ALL VP (classical) VCR 1～2mg+ NS 20cc V qw Prednisone 20~30mg/d p .o use it till CR , CR50% , but relapse easily VDLP VCR 1～2mg＋NS20cc V qw(1,8,15,21d) DNR 30～40mg V gtt qd 1～3d, 15～17d Pred 40mg～60mg p.o 1～14d L-ASP 10,000u V gtt 19－28d CR 72~77% VP16 0.2 V gtt qd ×3d Ara -C 0.1～0.15 V gtt qd×7d MTX 2～3g V gtt 24h, after 12h, leucovorin 0.06～0.1 iv q8h ×2d hydrotherapy alkalize It could be used in CNS leukemia * xie Yi,Hua Shan Hospital * （2） for ANLL HOAP(classical) VCR 1～2mg V 1d harringtonine 1～4mg V gtt qd×5－7d (interval 14d) Ara－C 50－100mg V gtt Bid×5－7d Prednisone 30－60mg p.o qd×5－7d HA harringtonine 2-4mg V gtt×7 Ara-C 0.1～0.2 V gtt×7 HD Ara-C Ara-C 2.0 V gtt q12h×3 DA DNR 30 ~ 40mg V gtt×3 Ara-C 0.1～0.2 V gtt×7 CR 65~85% * xie Yi,Hua Shan Hospital * （3） other Regimen for induced remission PML(M3): retinoid acid(ATRA)60－80mg p.o May add As2O3 5mg V gtt×28d Use chemotherapy in consolidation stage Use the low molecular heparin when with DIC Hypoplastic leukemia: CAG/CHG Ara-C 12.5mg M qd×21d harringtonine 1mg M / aclarubicin 10mg V qd×21d G-CSF300?g M qd ×21d Hyperplastic leukemia (WBC100×109/L) Therapeutic Leukapheresis to control the Leukostasis To prevent tumor lysis syndrome Immunotherapy : CD33 monoantibody +drug * xie Yi,Hua Shan Hospital * (4) treatment of CNS leukemia Incidence : ALL 10－40%，ANLL 2－4% Could be found in youth age， who suffered from infiltration, easily onset in remission stage always Clinical manifestation Intracranial hypertension The signs of meninges stimulated the signs