Eppinger-Helft M, Pavlovsky S, Suarez A, Muriel F S, Hidalgo G, Pavlovsky A, Vilaseca G
Cancer. 1975 Feb;35(2):347-53. doi: 10.1002/1097-0142(197502)35:2<347::aid-cncr2820350208>3.0.co;2-y.
A total of 114 previously untreated patients with myeloblastic leukemia was included in a sequential therapy protocol. Daunorubicin, vincristine, and prednisone were employed for the first 3 weeks, followed by two or more 5-day courses of cytosine arabinoside and 6-mercaptopurine; there was a 5-day rest between courses. Maintenance therapy was as follows: the continuing 6-mercaptopurine and methotrexate treatment was interrupted every 30 days for sequential reinforcement courses consisting of one dose of daunorubicin and vincristine and 7 days of prednisone, or by a 5-day course of cytosine arabinoside plus 6-mercaptopurine. Of the 114 patients, 48 obtained complete remission, 14 had partial remission, 16 failed to respond, and 36 died during the course of treatment. The remission rate in children (under 16) was 57%; in adults (16-45) 54%; and in those over 45, 19%. The difference in the incidence of complete remission in patients under 45 and those over 45 was statistically significant (p less than 0.01). The median duration of complete remission was 8 months: 12 months in children and 5 months in adults. The over-all survival rate was 4 months: 13 months for patients with complete remission, 4 months for those with partial remission, and 1 month for patients who did not respond to therapy. The difference in survival of those with complete remission and all the others was significant (p less than 0.01).
114例既往未接受过治疗的髓细胞性白血病患者被纳入一项序贯治疗方案。柔红霉素、长春新碱和泼尼松在前3周使用，随后是两个或更多疗程的5天阿糖胞苷和6-巯基嘌呤治疗；疗程之间有5天的休息期。维持治疗如下：持续的6-巯基嘌呤和甲氨蝶呤治疗每30天中断一次，进行序贯强化疗程，包括一剂柔红霉素和长春新碱以及7天的泼尼松，或进行一个5天的阿糖胞苷加6-巯基嘌呤疗程。在这114例患者中，48例获得完全缓解，14例部分缓解，16例无反应，36例在治疗过程中死亡。儿童（16岁以下）的缓解率为57%；成人（16 - 45岁）为54%；45岁以上的为19%。45岁以下和45岁以上患者完全缓解发生率的差异具有统计学意义（p小于0.01）。完全缓解的中位持续时间为8个月：儿童为12个月，成人为5个月。总体生存率为4个月：完全缓解的患者为13个月，部分缓解的患者为4个月，对治疗无反应的患者为1个月。完全缓解患者与其他所有患者的生存率差异显著（p小于0.01）。
