Mi Ying-chang, Xue Yan-ping, Yu Wen-juan, Liu Shi-he, Zhao Yao-zhong, Meng Qing-xiang, Bian Shou-geng, Wang Jian-xiang
Institute of Hematology, CAMS & PUMC, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2005 Dec;26(12):705-9.
To analyze the complete remission (CR) rate, disease free survival (DFS) and overall survival (OS) of de novo acute myeloid leukemia (AML) patients treated with HA based three drugs induction chemotherapy and to explore the impact of cytogenetic abnormalities on the prognosis.
Two hundred and forty-three untreated de novo AML patients were treated with HA based three drugs induction therapy. CR rate, DFS and OS were calculated. One hundred and eighty-four patients who had karyotype results were divided into four or three groups according to SWOG or MRC criteria respectively. Differences in CR rate, DFS and OS among different groups were evaluated.
The CR rate of all the 243 cases was 77.4%. The median DFS of the 188 CR patients was 28.5 (ranged from 1.0 to 153.0) months, DFS rates at 3 and 5 years were 45.4% and 40.2% respectively. The median OS of the 243 patients was 18.4 (range from 0.5 to 154.0) months. OS rates at 3 and 5 years were 36.9% and 31.4% respectively. According to SWOG criteria, CR rate, median DFS and OS were 97.8%, 87.4 months and 89.0 months for the favorable group; 81.9%, 17.6 months and 22.3 months for the intermediate group; 61.5%, 9 months and 11.5 months for the adverse group; and 79.3%, 29.0 months, 19.9 months for the unknown group, respectively. The differences among the four groups were statistically significant (P < 0.001). According to MRC criteria, CR rate, median DFS and OS were 96.1%, 79.9 months, 72.2 months for the favorable group; 80%, 17.6 months, 19.7 months for the intermediate group; and 43.8%, 16.5 months, 12 months for the adverse group, respectively. The differences among the three groups were statistically significant excepting for DFS between intermediate and adverse groups.
HA based triple-drug induction regimens are highly effective in obtaining higher CR rate and longer survival time. Cytogenetics is the important prognostic factor for AML patients and SWOG karyotype subtyping criteria is more appropriate than that of MRC, the differences among the three groups being statistically significant.
分析接受以HA为基础的三药诱导化疗的初治急性髓系白血病（AML）患者的完全缓解（CR）率、无病生存期（DFS）和总生存期（OS），并探讨细胞遗传学异常对预后的影响。
243例未经治疗的初治AML患者接受以HA为基础的三药诱导治疗。计算CR率、DFS和OS。184例有核型结果的患者分别根据SWOG或MRC标准分为四组或三组。评估不同组之间CR率、DFS和OS的差异。
243例患者的CR率为77.4%。188例CR患者的中位DFS为28.5（范围1.0至153.0）个月，3年和5年DFS率分别为45.4%和40.2%。243例患者的中位OS为18.4（范围0.5至154.0）个月。3年和5年OS率分别为36.9%和31.4%。根据SWOG标准，有利组的CR率、中位DFS和OS分别为97.8%、87.4个月和89.0个月；中间组分别为81.9%、17.6个月和22.3个月；不利组分别为61.5%、9个月和11.5个月；不明组分别为79.3%、29.0个月、19.9个月。四组之间的差异具有统计学意义（P<0.001）。根据MRC标准，有利组的CR率、中位DFS和OS分别为96.1%、79.9个月和72.2个月；中间组分别为80%、17.6个月和19.7个月；不利组分别为43.8%、16.5个月和12个月。除中间组和不利组之间的DFS外，三组之间的差异具有统计学意义。
以HA为基础的三联诱导方案在获得较高CR率和较长生存时间方面非常有效。细胞遗传学是AML患者重要的预后因素，SWOG核型亚型分类标准比MRC的更合适，三组之间的差异具有统计学意义。
