Douer D, Ben-Bassat I, Singer A, Ramot B
Institute of Hematology, Chaim Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel Aviv University.
Harefuah. 1990 Jan 15;118(2):57-61.
Since 1984, 47 patients with untreated acute myeloid leukemia (AML) were hospitalized in a special hematology unit for aggressive chemotherapy. Complete remission was obtained in 68%, 15% died of complications of treatment (infections and bleeding) and 15% had refractory leukemia. The actuarial survival after 3 years for patients in remission was 43%. No patients with refractory leukemia lived more than 1 year. The actuarial remission at 3 years of 21 patients who received additional courses of aggressive chemotherapy (consolidation treatment) was 42%, as opposed to 11% in 11 patients who received maintenance treatment. The 47 patients received 108 courses of aggressive chemotherapy including 47 for induction of remission. During 86 courses (80%) the patients developed fever and in 33 blood cultures were positive; during 16 courses a fungal infection developed. The most common bacterial infection was by E. coli. During the first induction treatment 5 patients died of sepsis and 1 of cerebral hemorrhage. None died during consolidation therapy. During the year preceding the opening of the unit, 12 AML patients were treated on regular medical wards, and five (42%) achieved a complete remission, while 6 died of complications during the first course of induction chemotherapy. Our findings are in line with those of similar units, which indicates the importance of special nursing units for the treatment of acute leukemia.
自1984年以来，47例未经治疗的急性髓系白血病（AML）患者入住一个特殊血液科病房接受强化化疗。68%的患者获得完全缓解，15%死于治疗并发症（感染和出血），15%患有难治性白血病。缓解患者3年的精算生存率为43%。没有难治性白血病患者存活超过1年。接受额外强化化疗疗程（巩固治疗）的21例患者3年精算缓解率为42%，而接受维持治疗的11例患者为11%。这47例患者共接受了108个强化化疗疗程，其中47个用于诱导缓解。在86个疗程（80%）中患者出现发热，33次血培养呈阳性；16个疗程中发生真菌感染。最常见的细菌感染是大肠杆菌感染。在首次诱导治疗期间，5例患者死于败血症，1例死于脑出血。巩固治疗期间无患者死亡。在该病房启用前一年，12例AML患者在普通内科病房接受治疗，5例（42%）获得完全缓解，6例在首次诱导化疗疗程中死于并发症。我们的研究结果与类似病房的结果一致，这表明特殊护理病房对急性白血病治疗的重要性。
