Total body irradiation of chronic lymphocytic leukemia: Incidence and duration of remission
Total body irradiation of chronic lymphocytic leukemia: Incidence and duration of remission
复制标题
慢性淋巴细胞白血病的全身照射：发病率和缓解持续时间
作者：
Ralph E. Johnson
本文回顾了17例连续未接受治疗的有症状（活动性）慢性淋巴细胞白血病患者全身照射的结果。所有患者均给予诱导疗程，随后观察无维持治疗，以确定缓解持续时间。使用描述的分类来衡量治疗反应，17例患者中有16例被评估为具有良好的临床反应。这些应答者中有8人可触及的疾病和症状完全消失，出现贫血时得到纠正，白细胞计数和差异计数在治疗结束后恢复正常（I型应答）。其余8名应答者客观上和主观上均有较不完全但明确的改善（II型应答）。未维持的缓解持续时间从诱导治疗完成到复发，后者被定义为任何疾病复发的证据，即使无症状。与II型应答者（4个月）相比，I型应答者的中位缓解持续时间明显更长（19个月）。这与实验性L1210和人类急性白血病的经验相似，其中未维持缓解的持续时间与治疗后幸存的剩余白血病细胞的数量成反比。实现这些高质量缓解的能力为未来慢性淋巴细胞白血病患者的生活质量和生存时间的实质性改善提供了一些前景。
The results of total body irradiation for 17 consecutive patients with symptomatic (active) chronic lymphocytic leukemia who had received no prior therapy are reviewed. All patients were given an induction course of treatment and subsequently observed without maintenance therapy to determine the duration of remission. Using a described classification to measure therapeutic response, 16 of the 17 patients were evaluated to have had favorable clinical responses. Eight of these responders had complete disappearance of palpable disease and symptoms, correction of anemia when present, and restoration of the white blood count and differential count to normal following completion of therapy (Type I response). The remaining 8 responders had less complete but definite improvement both objectively and subjectively (Type II response). The duration of unmaintained remission was measured from completion of induction therapy to relapse, the latter being defined as any evidence of recurring disease, even though asymptomatic. The median duration of remission was significantly longer for the Type I (19 months) as compared to the Type II (4 months) responders. This parallels the experience with both experimental L1210 and human acute leukemia wherein the duration of unmaintained remission is inversely related to the number of residual leukemic cells surviving treatment. The ability to achieve these high quality remissions offers some prospect of materially improving both the quality of life and survival time of chronic lymphocytic leukemia patients in the future.