EFFICACY OF INTENSIVE CHEMOTHERAPY FOR ACUTE MYELOGENOUS LEUKEMIA ASSOCIATED WITH A PRELEUKEMIC SYNDROME
EFFICACY OF INTENSIVE CHEMOTHERAPY FOR ACUTE MYELOGENOUS LEUKEMIA ASSOCIATED WITH A PRELEUKEMIC SYNDROME
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DOI：
10.1200/jco.1989.7.11.1637
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发表时间：
1989-11-01
影响因子：
45.3
通讯作者：
CHAMPLIN, RE
中科院分区：
文献类型：
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作者：
GAJEWSKI, JL;HO, WG;CHAMPLIN, RE
一百九十六名急性髓性白血病 (AML) 患者接受了强化诱导化疗，使用类似的柔红霉素/阿糖胞苷/硫鸟嘌呤方案。将 44 名在发展为明显 AML 之前患有白血病前期综合征或血细胞减少症持续超过 2 个月的患者与 152 名新发 AML 患者的治疗结果进行比较。与 111 名新发 AML 患者 (73%) 相比，18 名 (41%) 白血病前期患者获得完全缓解 (P < .01)。患有白血病前期-AML的患者粒细胞恢复的时间明显更长。多变量分析表明，既往存在白血病前期综合征和年龄增长是缓解缓解的独立不良预后指标。对于获得缓解的患者，无病生存期和总生存期也低于既往患有白血病前期的患者；无病生存期为 17.+-。 3 年时为 17%，而 29 .+- 时。新发 AML 患者为 10% (P = .02)。这些数据表明，强化化疗对于白血病前期综合征后的 AML 患者疗效有限。一些患者可能会获得持久缓解。
One hundred nintey-six patients with acute myelogenous leukemia (AML) were treated with intensive induction chemotherapy using similar daunorubicin/cytarabine/thioguanine regimens. Treatment results of 44 patients who had a documented preleukemic syndrome or cytopenia present for more than 2 months before developing overt AML were compared with 152 patients with de novo AML. Eighteen (41%) patients with preleukemia evolving into AML achieved complete remission compared with 111 (73%) patients with de novo AML (P < .01). Patients with preleukemia-AML had a significantly longer period to recovery of granulocytes. Multivariate analysis indicated that presence of a previous preleukemic syndrome and advancing age were independent poor prognostic indicators for archieving remission. For patients who achieved remission, disease-free survival and overall survival were also inferior for patients with previous preleukemia; disease-free survival was 17 .+-. 17% at 3 years compared with 29 .+-. 10% in patients with de novo AML (P = .02). These data indicate that intensive chemotherapy has limited efficacy in patients with AML following a preleukemic syndrome. Durable remissions may be achieved in some patients.