Patients with t(8;21)(q22;q22) and acute myeloid leukemia have superior failure-free and overall survival when repetitive cycles of high-dose cytarabine are administered
Patients with t(8;21)(q22;q22) and acute myeloid leukemia have superior failure-free and overall survival when repetitive cycles of high-dose cytarabine are administered
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DOI：
10.1200/jco.1999.17.12.3767
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发表时间：
1999-12-01
影响因子：
45.3
通讯作者：
Bloomfield, CD
中科院分区：
文献类型：
--
作者：
Byrd, JC;Dodge, RK;Bloomfield, CD
目的：观察大剂量阿糖胞苷诱导治疗对t(8；21)(q22；q22)核型急性髓系白血病(AML)患者的疗效。在这些研究中，给予大于或等于三个周期的大剂量阿糖胞苷或一个周期的大剂量阿糖胞苷，然后依次给予环磷酰胺/依托泊苷和米托蒽醌/二氮酮，并给予或不给予非格列汀支持。结果：50例初诊AML患者和t(8；21)患者被分配接受1个周期(n=29)或大于或等于3个周期(9=21)的大剂量阿糖胞苷作为诱导后治疗。两组患者的临床特征相似。被分配到大剂量阿糖胞苷一个周期的t(8；21)患者的初始缓解时间明显较短(P=0.03)，与接受大于或等于三个周期的患者相比，62%的患者复发，中位无失败生存时间为10.5个月，其中只有19%的患者复发，无失败生存时间估计大于35个月。此外，在被分配给一个周期的大剂量阿糖胞苷的患者中，总生存率也显著降低(P=0.04)，59%的患者死于急性髓系白血病，而接受大于或等于三个周期的大剂量阿糖胞苷的患者中，这一比例为24%。结论：这些数据表明，t(8；21)(q22；q22)患者的无失败生存率和总生存率可能会受到不包括序贯大剂量阿糖胞苷治疗的影响。J Clin Oncol17：3767-3775。(C)1999年，由美国临床肿瘤学会主办。
Purpose: To examine the effect of single compared with repetitive (at least three) cycles of high-dose cytarabine after induction therapy for patients with acute myeloid leukemia (AML) who have the t(8;21)(q22;q22) karyotype.Patients and Methods: Patients entered onto the study had AML and t(8;21) and attained a complete remission on four successive Cancer and Leukemia Group B studies. In these studies, either greater than or equal to three cycles of high-dose cytarabine or one cycle of high-dose cytarabine was administered, followed by sequential cyclophosphamide/etoposide and mitoxantrone/diaziquone with or without filgrastim support. Outcomes of these two groups of t(8;21) patients were compared.Results: A total of 50 patients with centrally reviewed AML and t(8;21) were assigned to receive one (n = 29) or greater than or equal to three cycles (9 = 21) of high-dose cytarabine as postinduction therapy. The clinical features of these two groups of patients were similar. Initial remission duration for t(8;21) patients assigned to one cycle of high-dose cytarabine was significantly inferior (P =.03), with 62% of patients experiencing relapse with a median failure-free survival of 10.5 months, compared with the group of patients who received greater than or equal to three cycles, in which only 19% experienced relapse and failure-free survival is estimated to be greater than 35 months. furthermore, overall survival was also significantly compromised (P =.04) in patients assigned to one cycle of high-dose cytarabine, with 59% having died as a consequence of AML, compared with 24% of those who received greater than or equal to three cycles of high-dose cytarabine.Conclusion: These data demonstrate that failure-free survival and overall survival of patients with t(8; 21)(q22;q22) may be compromised by treatment approaches that do not include sequential high-dose cytarabine therapy. J Clin Oncol 17:3767-3775. (C) 1999 by American Society of Clinical Oncology.