Leukemia treatment measures

1. Treatment principles : for the treatment of chronic myeloid leukemia in the not too hastily, leukocyte count in 100 × 109 / L in patients without immediate treatment, because the cycle is mature myeloid, compared with the original size of small cells with good deformation, leukocyte count in 200 × 109 / L are required to take active measures. Current to cytotoxic drugs used for chemotherapy. For those who proliferation and interleukin extreme the symptoms, if priapism, respiratory distress, blurred vision, psychopathic, should acute during the WBC removed on the basis of combined inhibitor for the treatment of bone marrow. 2. Chemical treatment : effective drugs BUS (busulfan), HU (hydroxyurea), CTX, CLB 6-MP (6-mercaptopurine), MMC (MMC). With the drug of first choice for the BUS, followed by HU. BUS is the most effective drug, the remission rate above 95%, easy to take advantage of this medicine. Usage of 2mg three times a day, have been used to WBC 14 × 109 / L suspended or intermittent administration. The general rule is to use a two-week subjective symptoms improved, 4 to 6 weeks improved markedly. When the WBC to 10 × 109 / L, a reduction to 2 mg / d, has remained two to three months. After stopping the drug, such as interleukin fluctuations in 10 ~ 50 × 109 / L, may consider maintaining a small dose of more than a year. Leukocyte reduction of 5 ~ 10 × 109 / L, platelets 100 x 109 / L, or slow the rapid changes tablets should only be inclined to stop. Busulfan the major toxicity was myelosuppression, especially thrombocytopenia. Although the individual patient doses will not arise to reduce blood cells, slow recovery. Long-term use of this drug can cause pulmonary fibrosis, skin pigmentation. Similar chronic Hypoadrenocorticism symptoms, semen or lack stopped. HU began daily dose of 3g, oral. After several leukocyte decline soon. When reduced to 20 x 109 / L, the dose will be reduced to half; Reduced to 10 × 109 / L, the dose will be further reduced. A daily dose of about 0.5 to 1.0g. Generally not completely stop, stop by the WBC after rising soon. The drug is the role of merit faster; If the WBC too much, stop quickly after rising; Less side effects. Weakness is often need blood tests to guide treatment. It can also α-interferon (IFN-α) in the treatment of chronic myeloid leukemia. , Oral HU2.0 ~ 6.0g / d, while subcutaneous injection. Α - IFV300 10,000 u, iv, three times a week, applications 8 to 32 weeks. When the WBC 10 × 109 / L, HU reduce continue to use a two-week, or out of a small dose. HU maintenance dose from 0.5 to 1.0 / d, conditional use may continue. Α - IFN300 10,000 u, iv, once weekly. Drug investigations during weekly routine two times, like bone marrow every four weeks inspections. 3. Radiation therapy : deep x line, with deep X-ray on systemic and local areas and infiltration spleen irradiation site. Splenic irradiation dose began to 50cGy, after a day or every other day to 100 cGy. WBC 20 × 109 / L stop. The good effect of chemotherapy or recurrence of radiotherapy can be used, it was reported that the efficacy of not less than BUS. Radionuclide 32P treatment, only for the BUS radiotherapy and spleen were ineffective. 32P dose is increased leukocyte the extent to which, if the WBC> 50 × 109 / L, 32P start dose for a ~ 2.5mCi, intravenous. Two weeks later with a ~ 1.5mCi, after every two weeks to the same dose of a meeting, the question WBC 20 × 109 / L suspended. In mitigation, every one to three times a month observation, when WBC> 25 x l09 / L, can give a ~ 1.5mCi. 4. Splenectomy : spleen may be slow tablets of the rapid changes in the starting position, might delay the removal of the spleen and the extension of the rapid changes in patient survival. The surgery to remove his spleen indications : ?٠diagnosed as chronic myeloid leukemia; ?ڠgood response to chemotherapy; ?۠below the age of 65 with no major surgery were followed. Chronic myeloid leukemia is a radical change surgery followed. 5. Bone marrow transplantation : the age of 45 ~ 50 at the age of the patients in chronic phase, HLA-identical siblings of allogeneic bone marrow for transplantation. Successful transplantation, general access to long-term survival or cure. 6. Other treatments : chemotherapy if the number of leukocytes in 500 × 109 / L, first blood cell separator for removing leukocytes to rapidly reduce the number of leukocytes and avoid excessive WBC microvascular obstruction may be caused by cerebrovascular accident risk. At the beginning of chemotherapy, especially the use of Hu treatment, it should also increase with Apurin 0.1g three times a day to prevent cell damage and excessive speed caused uric acid kidney disease. 7. Slow tablets of the rapid changes in the treatment : slow tablets of the rapid changes in the treatment of acute leukemia than the treatment difficulties, easing only 10.7%, the current slow tablets of the rapid changes in the treatment programs are as follows : Ara-c (Central cytarabine) 100mg/m2 d, 1 to 14 days; ADM ( adriamycin) 30mg/m2 d, 1 to 3 days; VCR2mg, an days; these drugs have intravenous infusion. PDN40mg/m2 d-oral, l ~ 7 days.