In vitro chemosensitivity by MTT assay and clinical outcomes in childhood leukemia

我们研究了196例新诊断ALL患儿体外敏感性与临床预后的关系。我们探讨了对四种药物DPAV （Dex, Pred, Asp， VCR）联合的敏感性是否预测诱导失败和早期复发（IF/ e.l l）。[患者和方法]入选病例为1989 - 1995年间新诊断的非b细胞ALL患儿（0-16岁）。BM样品被送去进行体外药物测试。普通ALL (cALL) 142例，T-ALL 21例，混合ALL (mix ALL) 28例，未分化ALL (wall) 5例。所有患者（pts）均采用标准风险的Pred、Asp和VCR +高风险的CPA和DNR的All方案作为诱导治疗。体外试验采用4天培养和MTT试验。我们测试了16种药物，并计算了14种药物的LD70，以及Dex和Pred的LCS。对于每种单一药物，患者分为两组，S组（低于中位LD70或LCS）或R组（高于中位l70或LCS）。【统计学】使用Stat View-J4.5 （Abacus Concepts）对EFS进行Kaplan-Meier法、log rank检验、Fisher’s PLSD和列联表分析进行多变量比较。[结果]cALL、T-ALL、mix ALL、wall患者的3年EFS分别为0.727、0.560、0.534、0.600。S组患者的Pred、VP16、VCR和MIT的EFS优于R组（p<0.05）。根据对四种药物（DPAV）的敏感性将患者分为S、I、R三组，S组（n=41）的EFS（3年）为0.833，I组（n=78）为0.752，R组（n=74）为0.546 （p=0.0011）。然后我们研究了S或R的药物敏感性是否与三个预后组（CCR,IF/e）相关。Rel，晚期复发)。5组Pred、BLM、VP16、VCR、MIT与CCR、R与IF/e显著相关。rel (p < 0.05)。当我们使用S，I和R作为DPAV敏感性时，S和I患者倾向于维持CCR，而R患者倾向于进行IF/e。Rel和晚期复发（p=0.004）。[结论]体外药敏试验联合免疫标志物检测可为儿童ALL提供预后信息。少

We investigated the relationship between in vitro sensitivity and clinical outcomes in 196 children with newly diagnosed ALL.We explored whether the sensitivity to a combination of four drugs DPAV (Dex, Pred, Asp, VCR) predicted induction failure and early relapse (IF/e.rel). [Patients and Methods] Eligible were children (age 0-16 years) with non-B cell ALL,newly diagnosed between 1989 and 1995. BM samples were sent for in vitro drug tests. There were 142 samples of common ALL (cALL), 21 of T-ALL,28 of mixed lineage ALL (mix ALL) and 5 of undifferentiated ALL (uALL). All patients (pts) were treated with the ALL protocol of Pred, Asp and VCR for standard risk, plus CPA and DNR for high risk, as induction therapy. In vitro tests were carried out with a four-day culture and MTT assay. We tested 16 drugs and calculated LD70 for 14 drugs, and LCS for Dex and Pred.For each single drug, pts were classified into two groups, as either S (lower than median LD70 or LCS) or R (higher than median L … More D70 or LCS).[Statistics] The Kaplan-Meier method for EFS,log rank test, Fisher's PLSD,and contingency table analysis for multi-variate comparison were conducted using Stat View-J4.5 (Abacus Concepts).[Results] EFS (3 yrs) of pts with cALL,T-ALL,mix ALL,uALL were 0.727,0.560,0.534,0.600 respectively. S group pts for Pred, VP16, VCR and MIT had superior EFS to R group pts (p<0.05). When we classified pts into three groups (S,I,R) by sensitivity to four drugs (DPAV), EFS (3 yrs) of S group (n=41) was 0.833, that of I (n=78) was 0.752, and that of R (n=74) was 0.546 (p=0.0011). Then we investigated whether the drug sensitivity of S or R was related to three prognostic groups (CCR,IF/e.rel, late relapse). S groups of Pred, BLM,VP16, VCR,MIT were significantly related to CCR,and R to IF/e.rel (p<0.05). When we used S,I and R for DPAV sensitivity, S and I pts tended to maintain CCR,and R pts tended to undergo IF/e. rel and late relapse (p=0.004). [Conclusion] In vitro drug sensitivity testing together with immunological marker testing provides prognostic information for childhood ALL. Less