Evans C, Winkelstein A, Rosenfeld C S, Zeigler Z R, Shadduck R K
University of Pittsburgh, School of Medicine, Department of Internal Medicine, Montefiore Hospital, Pennsylvania.
Cancer. 1990 Jun 15;65(12):2624-30. doi: 10.1002/1097-0142(19900615)65:12<2624::aid-cncr2820651204>3.0.co;2-t.
The effectiveness and toxicities of high-dose cytosine arabinoside with L-asparaginase (HiDAC-ASNase) were evaluated in 41 patients with "poor risk" acute nonlymphocytic leukemia (ANLL). Twenty-four patients had either refractory or relapsed primary ANLL, and 17 had ANLL secondary to prior cytotoxic chemotherapy or an underlying hematologic disorder. The overall complete remission (CR) rate was 37%. The CR rates for primary and secondary ANLL were almost identical. Furthermore, advanced age alone did not adversely influence the CR rate. The median CR duration was 302 days with no differences between primary and secondary ANLL. The induction death rate was 24%. Predictors for induction deaths included poor initial performance status, fever at the time of presentation, low cholesterol and/or albumin, and an initial bone marrow aspirate with greater than 50% blasts. These data indicate that HiDAC-ASNase is a moderately effective regimen for patients with poor prognosis ANLL including secondary ANLL.
在41例“高危”急性非淋巴细胞白血病（ANLL）患者中评估了大剂量阿糖胞苷联合L-天冬酰胺酶（HiDAC-ASNase）的有效性和毒性。24例患者为原发性难治性或复发性ANLL，17例患者为先前细胞毒性化疗或潜在血液系统疾病继发的ANLL。总体完全缓解（CR）率为37%。原发性和继发性ANLL的CR率几乎相同。此外，单纯高龄对CR率没有不利影响。CR持续时间的中位数为302天，原发性和继发性ANLL之间无差异。诱导死亡率为24%。诱导死亡的预测因素包括初始体能状态差、就诊时发热、低胆固醇和/或低白蛋白，以及初始骨髓穿刺涂片中原始细胞大于50%。这些数据表明，HiDAC-ASNase对于包括继发性ANLL在内的预后不良的ANLL患者是一种中等有效的治疗方案。
