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50年代,儿童急性淋巴细胞白血病(ALL)的平均生存时间为3个月。随着化疗的进展,缓解率从低于5%一跃而达90%左右,平均生存期延长至2-3年。不幸的是大部分患儿在缓解后出现中枢神经系统(CNS)和血液系统的复发,说明系统化疗药物不能有效地透过血脑屏障,杀灭存在于CNS的白血病细胞。到70年代,由于中枢神经系统预防治疗(CNSP)的应用,使5年无病生存率达到50-60%。尽管CNSP被认为是治疗儿童ALL的巨大突破,但目前还不是十分完善的。随着ALL患儿存活率的不断提高,人们越来越注意到CNSP所造成的不良作用。本文对文献报道中的这方面资料做一综述。
In the 1950s, the average survival time of childhood acute lymphoblastic leukemia (ALL) was 3 months. With the progress of chemotherapy, the remission rate jumped from less than 5% to about 90%, and the average survival period was extended to 2-3 years. Unfortunately, the majority of children relapse after the CNS and blood system remission, indicating that systemic chemotherapy drugs can not effectively penetrate the blood-brain barrier and kill leukemic cells that exist in the CNS. By the 1970s, the five-year disease-free survival rate was 50-60% due to the use of central nervous system prophylaxis (CNSP). Although CNSP is considered a huge breakthrough for the treatment of childhood ALL, it is not yet perfect. With the increasing survival rate of ALL children, people pay more and more attention to the adverse effects caused by CNSP. This article reviews the literature in this area.