Saşmaz Ilgen, Tanyeli Atila, Bayram Ibrahim, Antmen Bülent, Yilmaz Levent, Küçükosmanoğlu Osman, Kilinç Yurdanur
Unit of Pediatric Hematology, Cukurova University Faculty of Medicine, Adana, Turkey.
Turk J Pediatr. 2004 Jan-Mar;46(1):32-7.
Anthracycline and cytosine arabinoside are used in combination as the standard therapy for remission induction of acute nonlymphoblastic leukemia. Idarubicin, a synthetic daunorubicin analogue, shows an improved spectrum activity and diminishes acute or chronic toxicity when compared with the other anthracyclines. This study has been carried out in our clinic in order to evaluate the efficiency of the acute nonlymphoblastic leukemia protocol which includes idarubicin. Thirty-eight patients admitted to our Department between 1992-1999 and diagnosed as acute nonlymphoblastic leukemia (ANLL) were included in the study. Their median age was 7 years 6 months (range, 8 months to 14 years). Induction therapy consisted of idarubicin plus cytosine arabinoside and etoposide. Consolidation therapy consisted of two courses, followed by maintenance therapy with thioguanine, cytosine arabinoside, vincristine and cyclophoshamide. The complete remission rate was found to be 71%. The overall survival estimate was found to be 40% for one year and 23% for three years. We established that the protocol with idarubicin reached a higher remission ratio when compared with the other protocols with anthracycline. However, the degree of the hematologic toxicity ratios related to the therapy increased the complication ratios, which affected the long-term life analyses directly. Therefore this protocol may be revised according to socioeconomical conditions, especially in the developing countries.
蒽环类药物和阿糖胞苷联合使用是急性非淋巴细胞白血病缓解诱导的标准疗法。伊达比星是一种合成的柔红霉素类似物，与其他蒽环类药物相比，其活性谱有所改善，急性或慢性毒性降低。本研究在我们诊所开展，旨在评估包含伊达比星的急性非淋巴细胞白血病方案的疗效。1992年至1999年间入住我们科室且被诊断为急性非淋巴细胞白血病（ANLL）的38例患者纳入本研究。他们的中位年龄为7岁6个月（范围为8个月至14岁）。诱导治疗包括伊达比星加阿糖胞苷和依托泊苷。巩固治疗包括两个疗程，随后用硫鸟嘌呤、阿糖胞苷、长春新碱和环磷酰胺进行维持治疗。完全缓解率为71%。一年总生存估计为40%，三年为23%。我们确定，与其他含蒽环类药物的方案相比，含伊达比星的方案达到了更高的缓解率。然而，与治疗相关的血液学毒性比率程度增加了并发症比率，这直接影响了长期生存分析。因此，尤其是在发展中国家，该方案可能需要根据社会经济状况进行修订。
