Intermittent combination chemotherapy with adriamycin for childhood acute lymphoblastic leukemia: clinical results.
Intermittent combination chemotherapy with adriamycin for childhood acute lymphoblastic leukemia: clinical results.
复制标题
阿霉素间歇性联合化疗治疗儿童急性淋巴细胞白血病：临床结果。
作者：
S. Sallan;Bruce M. Camitfa;J. Cassady;D. G. Nathan;Emil Frei Ill
137名患有未经治疗的急性淋巴细胞白血病的儿童进入了一个新的项目，其中包括以阿霉素为特色的间歇性联合化疗。缓解诱导最初随机分配至长春新碱和泼尼松联合或不联合蒽环类药物。所有患儿均接受门冬酰胺酶巩固治疗和中枢神经系统预防治疗，包括头颅放疗和鞘内注射甲氨蝶呤。无CNS预防的原发性失败。并发症主要是感染。未观察到心脏毒性和白质脑病的临床证据。进入完全缓解的时间和诊断时存在前纵隔肿块被认为是统计学上显著的不良预后因素，而年龄和白色血细胞计数则不是。中位随访时间为26个月，使用生命曲线分析，65%的儿童持续完全缓解。
One hundred thirty-seven children with previously untreated acute lymphoblastic leukemia were entered into a new program that included intermittent combination chemotherapy featuring Adriamycin. Remission induction was initially randomized to vincristine and prednisone with or without an anthracycline. All children received asparaginase consolidation and central nervous system prophylaxis with cranial irradiation and intrathecal methotrexate. There were no primary failures of CNS prophylaxis. Complications were primarily infectious. Clinical evidence of cardiotoxicity and leukoencephalopathy were not observed. The time to enter complete remission and the presence of an anterior mediastinal mass at diagnosis were found to be statistically significant adverse prognostic factors, whereas presenting age and white blood count were not. With a median follow-up of 26 mo, and using life plot analysis, 65% of the children have remianed in continuous complete remission.