Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, IL, USA.
Leuk Lymphoma. 2010 Jun;51(6):995-1006. doi: 10.3109/10428191003763468.
Few clinical protocols have focused on patients with therapy-related myeloid neoplasms (t-MN). Therefore, we enrolled 32 patients with previously untreated t-MN on a clinical trial testing the effectiveness of a unified induction regimen of high-dose cytarabine and mitoxantrone. The complete remission (CR) rate was 66% (95% CI 47-81%) and the partial remission (PR) rate was 16% (95% CI 5-33%), for an overall response rate of 82%. Day 30 treatment mortality was 9% (3/32), and the most serious induction toxicity was cardiac dysfunction. Among the patients with CR, 13 (62%) received consolidation therapy using an allogeneic hematopoietic cell transplant (HCT), four (21%) received an autologous HCT, and three (16%) received further chemotherapy. We observed long-term disease-free survival in patients who received all three types of consolidation therapy. The remission induction of high-dose cytarabine and mitoxantrone for t-MN is a well-tolerated efficacious combination, which allows aggressive consolidation and long-term disease-free survival.
很少有临床方案关注治疗相关髓系肿瘤（t-MN）患者。因此，我们在一项临床试验中招募了 32 名未经治疗的 t-MN 患者，该试验测试了高剂量阿糖胞苷和米托蒽醌联合诱导方案的有效性。完全缓解（CR）率为 66%（95%CI 47-81%），部分缓解（PR）率为 16%（95%CI 5-33%），总缓解率为 82%。第 30 天治疗死亡率为 9%（3/32），最严重的诱导毒性是心脏功能障碍。在 CR 患者中，13 名（62%）接受了同种异体造血细胞移植（HCT）巩固治疗，4 名（21%）接受了自体 HCT，3 名（16%）接受了进一步化疗。我们观察到接受所有三种巩固治疗的患者具有长期无病生存。高剂量阿糖胞苷和米托蒽醌治疗 t-MN 的缓解诱导是一种耐受良好且有效的联合治疗方案，可进行强化巩固治疗并实现长期无病生存。
