Role of early anthracycline dose-intensity according to expression of Philadelphia chromosome/BCR-ABL rearrangements in B-precursor adult acute lymphoblastic leukemia.
Role of early anthracycline dose-intensity according to expression of Philadelphia chromosome/BCR-ABL rearrangements in B-precursor adult acute lymphoblastic leukemia.
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DOI：
10.1038/sj.thj.6200032
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发表时间：
2000-01-01
期刊：
影响因子：
--
通讯作者：
Barbui, T
中科院分区：
文献类型：
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作者：
Bassan, R;Rohatiner, A Z;Barbui, T
简介：使用蒽环类抗生素治疗成人急性淋巴细胞白血病（ALL）可以改善诱导缓解治疗的结果。然而，这些药物在巩固治疗中的确切作用尚不清楚，特别是在特定的 ALL 亚型中。 材料和方法：对 1974 年至 1998 年间接受八个连续方案治疗的 308 名最常见亚型早期 B ALL 患者（中位年龄 35 岁，范围 13-75 岁）的结果进行回顾性分析。通过评估计划的蒽环类药物剂量强度（A-DI）对长期结果的影响来评估与蒽环类药物相关的影响。巩固治疗前 12 周期间的 A-DI（以 mg/m(2)/周为单位）被分类为“高”（多柔比星>20，伊达比星>7）或“低”。 结果：78% 的病例获得完全缓解。中位随访时间为 6.5 年，根据多变量分析，无病生存 (DFS) 仅与费城 (Ph) 染色体的表达和/或相关的 BCR-ABL 重排 (Ph/BCR(+)) (P=0.0001) 和计划的 A-DI (P) 相关。
INTRODUCTION: The use of anthracycline antibiotics in adult acute lymphoblastic leukemia (ALL) has resulted in an improved outcome to remission induction therapy. However,the exact role of these drugs in consolidation therapy is less clear, especially in specific ALL subsets.MATERIALS AND METHODS: A retrospective analysis was conducted on the outcome of 308 patients (median age 35 years, range 13-75) with the most frequent subtype, early-B ALL, treated between 1974 and 1998 on eight consecutive protocols. Anthracycline-related effects were assessed by evaluating the impact of planned anthracycline dose-intensity (A-DI) on long-term outcome. A-DI (in mg/m(2)/week) during the first twelve weeks of consolidation therapy was classified as either "high" (doxorubicin>20, idarubicin>7) or "low".RESULTS: Complete remission was achieved in 78% of cases. With a median follow-up of 6.5 years, on multivariate analysis, disease-free survival (DFS) correlated only with expression of the Philadelphia (Ph) chromosome and/or associated BCR-ABL rearrangements (Ph/BCR(+)) (P=0.0001) and planned A-DI (P