Powell B L, Kute T E, Craig J B, Lyerly E S, Gregory B W, Do K A, Contento M M, Capizzi R L
Cancer Center of Wake Forest University, Winston-Salem, NC 27103.
Leukemia. 1990 May;4(5):316-20.
Therapy of acute myelogenous leukemia (AML) with sequential high-dose ara-C and asparaginase (HiDAC----ASNase) on a day 1 and 8 schedule was designed to exploit potential recruitment of residual leukemia cells following initial cytoreduction from day 1 treatment. DNA flow cytometry was used to evaluate the proliferative index (%S + G2M) of bone marrow leukemia cells from pretreatment and day 8 marrow samples. The proliferative index on day 1, day 8, and incremental change (day 8 minus day 1) were analyzed for their correlation with bone marrow aplasia on day 15 and with the attainment of subsequent complete remission. Pretreatment (day 1) and the change in proliferative index did not correlate (p greater than 0.10) with day 15 marrow aplasia or with clinical outcome. However, the magnitude of the day 8 proliferative index did relate to the attainment of bone marrow aplasia on day 15 (p = 0.05) and the attainment of complete remission (p = 0.002). Recruitment of residual leukemia cells into the proliferative phases of the cell cycle may contribute to the unique efficacy of the day 1 and 8 schedule of HIDAC----ASNase. Additionally, the cytokinetics of residual leukemia after initial chemotherapy may be predictive of outcome and could be useful as a marker for the design of optimal therapeutic regimens.
采用第1天和第8天序贯大剂量阿糖胞苷和天冬酰胺酶（大剂量阿糖胞苷-天冬酰胺酶）治疗急性髓性白血病（AML），旨在利用第1天治疗初始细胞减灭后残留白血病细胞的潜在募集作用。运用DNA流式细胞术评估预处理时和第8天骨髓样本中骨髓白血病细胞的增殖指数（%S + G2M）。分析第1天、第8天的增殖指数以及增殖指数的增量变化（第8天减去第1天）与第15天骨髓抑制以及后续完全缓解的相关性。预处理时（第1天）以及增殖指数的变化与第15天骨髓抑制或临床结局均无相关性（p大于0.10）。然而，第8天增殖指数的大小与第15天骨髓抑制的出现（p = 0.05）以及完全缓解的实现（p = 0.002）相关。残留白血病细胞募集进入细胞周期的增殖期可能有助于大剂量阿糖胞苷-天冬酰胺酶第1天和第8天治疗方案的独特疗效。此外，初始化疗后残留白血病细胞的细胞动力学可能预测结局，并且可用作设计最佳治疗方案的标志物。
