环孢素联合化疗逆转急性白血病多药耐药的临床研究
Cyclosporine A combined with chemotherapy in reversing multidrug resistance in patients with acute leukemia
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摘要: 目的: 探讨环孢素(cyclosporinA,CsA)联合化疗逆转急性白血病(acute leukemia,AL)多药耐药(multi drug resistance,MDR)的临床疗效。方法: 28例急性白血病患者随机分成逆转组(CsA联合化疗)和对照组(单用化疗),且对16例逆转组患者进行P-糖蛋白(P-gp)测定。结果: 逆转组总有效率68.8%,复治患者的完全缓解(CR)7/10,均高于对照组的总有效率(25.0%)和复治患者CR(1/8),差异均有显著性(P<0.05)。结论: CsA联合化疗可以克服白血病细胞的MDR,而且随着白血病细胞P-gp阳性表达率增高,CsA的耐药逆转作用可能会越明显。Abstract: Objective: To explore the effect of cyclosporin A(CsA) in reversing multidrug resistance(MDR) in patients with acute leukemia(AL).Methods: Twenty-eight cases of acute leukemia were randomly divided into therapeutic group(CsA plus chemotherapy) and control group(chemotherapy alone).The expression of P-glycoprotein(P-gp) was assayed in 16 cases of the therapeutic group.Results: The total effective rate was 68.8% and the complete remission(CR) rate of the patients receiving repetition treatment was(7/10) in the therapeutic group,while the total effective rate was 25.0% and the CR rate of the patients receiving repetition treatment was 1/8 in the control group.The difference was significant(P<0.05).Conclusions: The CsA combined with chemotherapy may reverse MDR in patients with acute leukemia.With the rise of the positive expressing rate of P-gp of the leukemia cells,CsA's reverse effect on MDR is more obvious.