RECOGNITION OF DRUG-RESISTANCE DURING REMISSION INDUCTION THERAPY FOR ACUTE NON-LYMPHOCYTIC LEUKEMIA - UTILITY OF DAY 6 BONE-MARROW BIOPSY
RECOGNITION OF DRUG-RESISTANCE DURING REMISSION INDUCTION THERAPY FOR ACUTE NON-LYMPHOCYTIC LEUKEMIA - UTILITY OF DAY 6 BONE-MARROW BIOPSY
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DOI：
10.1016/0145-2126(83)90059-0
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发表时间：
1983-01-01
影响因子：
2.7
通讯作者：
POTHIER, L
中科院分区：
文献类型：
--
作者：
PREISLER, H;BARCOS, M;POTHIER, L
虽然大多数70岁以下急性非淋巴细胞白血病患者在联合使用阿糖胞嘧啶和蒽环类抗生素治疗后病情得到缓解，但20-45%的患者没有缓解。这些患者治疗失败的原因各不相同，从耐药疾病到缓解诱导治疗开始后不久因感染或出血死亡。显然，更强化的缓解诱导治疗应该只给那些治疗强度不足的患者。接受65个疗程缓解诱导治疗的53例患者在治疗6天后进行骨髓活检。88%的缓解发生在第6天骨髓细胞含量< 62.5%的患者中，而78%的耐药患者第6天骨髓细胞含量超过62.5%。因此，在治疗6天后进行骨髓活检，可以识别大多数患者是否进入完全缓解期，或者是否需要更积极的治疗。
While the majority of patients under 70 yr of age with acute non-lymphocytic leukemia enter remission when treated with a combination of cytosine arabinoside and an anthracycline antibiotic, 20-45% of patients do not. The reasons for treatment failure in these patients vary from drug resistant disease to death from infection or bleeding shortly after remission induction therapy is initiated. Clearly, more intensive remission induction therapy should be administered only to those patients for whom the therapy being employed is of insufficient intensity. Bone marrow biopsies after 6 days of therapy have been performed on 53 patients who received 65 courses of remission induction therapy. Eighty-eight percent of the remissions occurred in patients whose marrow cellularity was < 62.5% on day 6 while 78% of patients who had drug resistant disease had day 6 marrow cellularities which exceeded 62.5%. Hence, a bone marrow biopsy performed after 6 days of therapy permits the recognition of the majority of patients who will enter complete remission or alternatively who need more aggressive therapy.