Acute lymphoblastic leukemia in adults and children. Differences in response with similar therapeutic regimens
Acute lymphoblastic leukemia in adults and children. Differences in response with similar therapeutic regimens
复制标题
成人和儿童急性淋巴细胞白血病。
作者：
T. Gee;M. Haghbin;M. Dowling;I. Cunningham;M. Middleman;B. Clarkson
23例成人患者（年龄大于15岁）和75例急性淋巴细胞白血病儿童患者接受了类似的强化、序贯细胞毒性方案（L-2）治疗。成人患者的缓解率（78%）低于儿童（98%）。成人的缓解期和生存期也较短。成人中枢神经系统（CNS）复发的发生率（27.7%）高于儿童（7.1%），表明儿童长期预防性鞘内注射甲氨蝶呤比仅在治疗前2个月鞘内注射甲氨蝶呤的成人治疗方案更有效。L2方案儿童CNS受累的发生率较低，优于其他报告的使用颅照射和鞘内甲氨蝶呤联合治疗的系列。在成人和儿童中，初始白色血细胞计数大于25，000个细胞/mm 3的患者中CNS受累的发生率似乎较高。
Twenty‐three adult patients (ages greater than 15 years) and 75 children with acute lymphoblastic leukemia were treated with similar intensive, sequential cytotoxic protocols (L‐2). The adult patients have a lower remission rate (78%) than the children (98%). The duration of remission and the length of survival are also shorter in adults. The incidence of central nervous system (CNS) relapse in adults (27.7%) is higher than in children (7.1%) suggesting that prolonged prophylactic intrathecal methotrexate as given to the children is more effective than the schedule used for adults where intrathecal methotrexate was given only in the first 2 months of therapy. The low incidence of CNS involvement in children on the L‐2 protocol compares favorably with other series reported using a combination of cranial irradiation and intrathecal methotrexate. In both adults and children there seemed to be a higher incidence of CNS involvement in patients with initial white blood cell counts greater than 25,000 cells/mm3.