Treatment of acute nonlymphocytic leukemia: use of anthracycline-cytosine arabinoside induction therapy and comparison of two maintenance regimens.
Treatment of acute nonlymphocytic leukemia: use of anthracycline-cytosine arabinoside induction therapy and comparison of two maintenance regimens.
复制标题
急性非淋巴细胞白血病的治疗：使用蒽环类-阿糖胞苷诱导治疗和两种维持方案的比较。
DOI：
10.1182/blood.v53.3.455.bloodjournal533455
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发表时间：
1979
期刊：
影响因子：
20.3
通讯作者：
D. Preisler
中科院分区：
文献类型：
--
作者：
H. Preisler;Y. Rustum;E. Henderson;S. Bjornsson;P. Creaven;D. Higby;A. Freeman;S. Gailani;C. Naeher;D. Preisler
急性非淋巴细胞白血病患者给予由阿糖胞嘧啶和蒽环类药物组成的缓解诱导治疗。那些经历完全缓解的患者接受了两个疗程的巩固治疗，并随机接受维持治疗，包括每3个月加强一次的每日化疗或每6周加强一次治疗。总体完全缓解率为66%，其中60岁以下未接受治疗且既往无恶性肿瘤病史的患者完全缓解率为80%。两种维持方案治疗的患者缓解时间相同。缓解诱导治疗成功的主要决定因素是患者的年龄，老年患者经常死于并发感染。有文献记载的白血病细胞对所采用的治疗的耐药性很少遇到。一旦达到缓解，年龄不再是患者生存的决定因素，因为缓解的持续时间与年龄无关。缓解持续时间与三磷酸阿糖糖胞嘧啶的白血病细胞保留率直接相关。因此，急性非淋巴细胞白血病的治疗可分为两个独立的领域：缓解诱导和缓解维持。
Patients with acute nonlymphocytic leukemia were given remission induction therapy consisting of cytosine arabinoside and an anthracycline. Those patients who experienced complete remission received two courses of consolidation therapy and were randomized to receive maintenance therapy consisting of either daily chemotherapy with reinforcements every 3 mo or reinforcement therapy only every 6 wk. The overall complete remission rate was 66%, with 80% complete remission for previously untreated patients less than 60 yr of age who did not have a prior history of malignancy. Remission durations were the same for patients treated with both maintenance regimens. The major determinant for successful remission induction therapy was patient age, with older patients frequently succumbing to intercurrent infection. Documented leukemic cell resistance to the therapy employed was only rarely encountered. Once remission was achieved, age was no longer a determinant of patient survival, since duration of remission was independent of age. Remission durations were directly related to leukemic cell retention of cytosine arabinoside triphosphate. Hence therapy for acute nonlymphocytic leukemia can be divided into two separate areas: remission induction and remission maintenance.