Chemotherapy of malignant histiocytosis in adults
Chemotherapy of malignant histiocytosis in adults
复制标题
成人恶性组织细胞增多症的化疗
作者：
M. Alexander;J. Daniels
恶性组织细胞增生症是一种对单一药物化疗耐药的暴发性肿瘤，可导致6个月内死亡。在1965-1975年间，斯坦福大学有16名患者接受了这种疾病的化疗。9名患者对化疗有反应。有反应的患者从出现症状开始的中位生存期为23个月，明显长于无反应的患者(p=0.03)。最有希望的反应是用环磷酰胺、阿霉素、长春新碱和强的松联合治疗的7名患者。七名患者中有五名有反应，其中两名后来复发并死亡，两名在接受6个月和9个月的化疗时有可疑的疾病证据，还有一名在完成8个月的化疗后17个月没有患病。三名患者中枢神经系统(CNS)复发，两名患者在外周缓解期间。其中一人通过脑部照射和鞘内注射甲氨蝶呤控制了中枢神经系统疾病，但三人最终全部死亡。希望通过联合化疗和预防性中枢神经系统治疗，实现长期无病生存。
Malignant histiocytosis is a fulminant neoplasm resistent to single agent chemotherapy and resulting in death within 6 months. Sixteen patients have received chemotherapy for this disorder between 1965–1975 at Stanford. Nine patients responded to chemotherapy. Responders had a median survival of 23 months from onset of symptoms and a significantly longer survival than non‐responders (p = 0.03). The most promising responses were in seven patients treated with a combination of cyclophosphamide, adriamycin, vincristine and prednisone. Five of the seven responded, with two of the five later relapsing and dying, two having equivocal evidence of disease while on chemotherapy for 6 and 9 months, and one free of disease for 17 months after completing 8 months of chemotherapy. Three patients had central nervous system (CNS) relapses, two during peripheral remission. One of these had control of CNS disease with brain irradiation and intrathecal methotrexate, but all three eventually died. It is hoped that with combination chemotherapy and prophylactic CNS treatment, long term disease‐free survivals will be achieved.