PLASMA-CELL LEUKEMIA - AN EVALUATION OF RESPONSE TO THERAPY
PLASMA-CELL LEUKEMIA - AN EVALUATION OF RESPONSE TO THERAPY
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DOI：
10.1016/0002-9343(87)90942-9
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发表时间：
1987-12-01
影响因子：
5.9
通讯作者：
KYLE, RA
中科院分区：
文献类型：
--
作者：
NOEL, P;KYLE, RA
43名浆细胞白血病患者在梅奥诊所就诊。25人（58%）患有原发性浆细胞白血病（在白血病期首次诊断），18人（42%）患有继发性浆细胞白血病（先前诊断的多发性骨髓瘤的白血病转化）。与原发性浆细胞白血病患者相比，继发性浆细胞白血病患者年龄更大，溶解性骨病变发生率更高，血小板计数更低，血清中m蛋白含量更高。原发性浆细胞白血病患者的中位生存期为6.8个月，继发性浆细胞白血病患者的中位生存期为1.3个月。在原发性浆细胞白血病患者中，多种烷基化药物比美法兰产生更高的缓解率，但从治疗到进展或死亡的中位时间并没有明显改善。文献回顾还表明，联合化疗的有效率高于单一烷基化剂。继发性浆细胞白血病患者通常对任何类型的化疗都有耐药性，生存期较短。
Forty-three patients with plasma cell leukemia were seen at the Mayo Clinic. Twenty-five (58 percent) had primary plasma cell leukemia (diagnosis first made in the leukemic phase) and 18 (42 percent) had secondary plasma cell leukemia (leukemic transformation of a previously diagnosed multiple myeloma). Patients with secondary plasma cell leukemia were older, had a greater incidence of lytic bone lesions, had a lower platelet count, and had a larger M-protein in the serum than did patients with primary plasma cell leukemia. The median survival was 6.8 months for patients with primary plasma cell leukemia and 1.3 months for patients with secondary plasma cell leukemia. In patients with primary plasma cell leukemia, multiple alkylating agents produced a higher response rate than did melphalan, but the median time from treatment to progression or death was not significantly improved with such therapy. Review of the literature also suggests that the response rate is higher with combination chemotherapy than with single alkylating agents. Patients with secondary plasma cell leukemia usually show resistance to any type of chemotherapy and have a short survival.