ADULT LEUKEMIA RESEARCH CENTER

首次或第二次缓解的ALL患者将包括 接受随机III期试验的主要患者组 在这一分项目中提议。基于可喜的结果 纪念斯隆·凯特琳移植团队将与 在14.4Gy超分割TBI计划之间 紧随其后的是CY和15.75GyTBI分割计划 在CY之前或之后。后一种方案的选择 将由正在进行的随机试验的结果来确定 比较颅脑损伤前后环磷酰胺的应用情况。未来 第三阶段试验将使用新的治疗方案进行设计 在I.A.和I.B.子项目中开发。我们将确定风险因素 与骨髓移植的成功或失败有关 明确骨髓移植在急性淋巴细胞白血病患者中的作用， 尤其是那些首次缓解的患者。

Patients with ALL in first or second remission will comprise the major patient group treated in randomized phase III trials proposed in this subproject. Based on promising results from the Memorial Sloan Kettering Transplant Team a comparison will be made between a schedule of 14.4 Gy of hyperfractionated TBI followed by CY and a fractionated TBI schedule of 15.75 Gy either preceded or followed by CY. Choice of the latter regimen will be determined by the results of an ongoing randomized trial comparing the administration of CY before or after TBI. Future Phase III trials will be designed using new treatment regimens developed in subprojects I.A. and I.B. We will identify risk factors associated with success or failure of marrow transplantation to define the role of marrow grafting in patients with ALL, especially those in first remission.