[成年急性白血病患者的形态学和免疫学分型及对化疗的反应]

[Morphological and immunological classification and response to chemotherapy in adult patients with acute leukemias].

作者信息

Ohshima T, Takeuchi J

机构信息

First Department of Internal Medicine, Nihon University School of Medicine, Tokyo.

出版信息

Rinsho Byori. 1990 Jun;38(6):675-82.

PMID:2381091

Abstract

Three hundred forty four adult patients with acute leukemia were classified according to the FAB classification, and revealed 109 patients were ALL and 235 were AML. Surface marker analysis were done in 52 cases with ALL and 51 with AML. Patients with ALL were treated with VP or LVP therapy and those with AML were treated with DC(M)P, BH-AC DMP, DCMP-85 or DBMP-85. L 1 was 56% of ALL patients and L 2 was 44%. Complete remission (CR) rate of L 1 was 78.8% and that of L 2 was 62.5%, however 5 year survival rate was less than 20% in both groups. c-ALL was 62% of ALL, T-ALL and N-ALL were 15% and 13% respectively. L + M ALL was 8% and B + T ALL was 2%. CR rate was almost same among each groups, however disease free survival (DFS) was better in T-ALL and worse in c-ALL. M 1 was 23.4% of AML, M 2, M 3, M 4, M 5 and M 6 were 42.6%, 15.7%, 11.9%, 5.1% and 1.3% respectively. CR rate of all AML was 71.9% and that of M 3, M 5 and M 6 was worse than the average. Five years continued complete remission (CCR) rate of M 2, M 3 and M 4 were 20-25%, while that of M 1 and M 5 were worse than the former. Myeloid-AML was 67% of AML, L + M-AML and lymphoid-AML were 27% and 6% respectively. CR and CCR rate of L + M-AML and lymphoid-AML were seemed to be better than those of myeloid-AML. Thus, the patients with AML, even though they have the blasts which express lymphoid markers, can be treated with AML directed therapy.

摘要

344例成年急性白血病患者按FAB分类法进行分类，结果显示109例为急性淋巴细胞白血病（ALL），235例为急性髓系白血病（AML）。对52例ALL患者和51例AML患者进行了表面标志物分析。ALL患者采用VP或LVP方案治疗，AML患者采用DC(M)P、BH-AC DMP、DCMP-85或DBMP-85方案治疗。ALL患者中L1型占56%，L2型占44%。L1型的完全缓解（CR）率为78.8%，L2型为62.5%，然而两组的5年生存率均低于20%。普通型ALL（c-ALL）占ALL的62%，T细胞ALL（T-ALL）和非T非B细胞ALL（N-ALL）分别占15%和13%。粒单型ALL（L+M ALL）占8%，双表型ALL（B+T ALL）占2%。各亚组的CR率相近，但T-ALL的无病生存期（DFS）较好，c-ALL较差。AML中M1型占23.4%，M2、M3、M4、M5和M6型分别占42.6%、15.7%、11.9%、5.1%和1.3%。所有AML的CR率为71.9%，M3、M5和M6型的CR率低于平均水平。M2、M3和M4型的5年持续完全缓解（CCR）率为20% - 25%，而M1和M5型则低于前者。髓细胞型AML占AML的67%，粒单型AML（L+M-AML）和淋巴细胞型AML分别占27%和6%。L+M-AML和淋巴细胞型AML的CR和CCR率似乎优于髓细胞型AML。因此，AML患者即使其原始细胞表达淋巴细胞标志物，也可采用针对AML的治疗方法进行治疗。