Raza A, Preisler H D, Day R, Yasin Z, White M, Lykins J, Kukla C, Barcos M, Bennett J, Browman G
Roswell Park Memorial Institute, Buffalo, NY.
Blood. 1990 Dec 1;76(11):2191-7.
Cell cycle characteristics including labeling indices (LI), duration of S-phase (Ts), and total cell cycle time (Tc) were determined in 54 standard-risk, newly diagnosed patients with acute myeloid leukemia following an infusion of bromodeoxyuridine. Remission induction therapy consisting of cytosine arabinoside and daunomycin was then administered to all patients, followed by three courses of consolidation to those who achieved complete remissions (CR). Older patients appeared to have more rapidly cycling cells (P = .003). No unique cell cycle characteristics were identified for patients who achieved remission versus those who had resistant disease. However, the pretherapy cell cycle characteristics were a strong prognosticator for remission duration. CR patients were divided into those whose leukemic cell Tc were above median (A) and below median (B). Among 14 B patients, median duration of response was 211 days, and all relapsed by day 600. Among 18 A patients, the median has not as yet been reached, with nine patients in continuous complete remission (log rank P = .007, Wilcoxon P = .04). We conclude that cell cycle characteristics of leukemic cells play a role in determining remission duration, perhaps because the leukemic cells of the former patients regrow slowly between courses of chemotherapy.
在54例新诊断的标准风险急性髓系白血病患者输注溴脱氧尿苷后，测定了包括标记指数（LI）、S期持续时间（Ts）和总细胞周期时间（Tc）在内的细胞周期特征。然后对所有患者给予由阿糖胞苷和柔红霉素组成的缓解诱导治疗，对达到完全缓解（CR）的患者进行三个疗程的巩固治疗。老年患者的细胞似乎增殖更快（P = 0.003）。未发现缓解患者与耐药患者有独特的细胞周期特征。然而，治疗前的细胞周期特征是缓解持续时间的有力预后指标。CR患者被分为白血病细胞Tc高于中位数的患者（A组）和低于中位数的患者（B组）。在14例B组患者中，中位缓解持续时间为211天，所有患者在第600天前均复发。在18例A组患者中，中位缓解持续时间尚未达到，9例患者持续完全缓解（对数秩检验P = 0.007，Wilcoxon检验P = 0.04）。我们得出结论，白血病细胞的细胞周期特征在决定缓解持续时间方面起作用，可能是因为前一组患者的白血病细胞在化疗疗程之间生长缓慢。
