Kawamura S, Kawarada R, Tsushima Y, Sawada Y, Yoshida Y, Chiba Y, Yamaya T, Kawatsu S, Aizawa M, Segawa M
First Dept. of Internal Medicine, Hirosaki University School of Medicine.
Gan To Kagaku Ryoho. 1989 Jan;16(1):83-7.
Between January 1980 and March 1983, a study was conducted on the effects of intensification therapy in 20 adult acute leukemia patients who had achieved complete remission with induction therapy. Intensification therapy consisted of cyclic administration of six combination therapies given at gradually longer intervals, using daunorubicin, cytosine arabinoside, 6-mercaptopurine and prednisolone (DCMP), cyclocytidine (DCyMP), vincristine (DCVP), behenoyl-ara-c (BHAC-DMP), aclacinomycin (BHAC-AMP) and (ACM-MP). Six combinations were given sequentially at one-month intervals, at 2-, 3-, 4-, 5- and eventually 6-month intervals, until 5-year survival. The median remission duration was 38 months for AML, and 17 months for ALL. The median survival was 66 months for AML, and 37 months for ALL. The five year survival rate was 50%. Nine of the 20 patients are still alive. Methotrexate and prednisolone were administered intrathecally for prophylaxis of CNS leukemia on Day 4 for each intensification therapy. There was no CNS leukemia. This intensification protocol was shown to be effective in improving the prognosis of adults acute leukemia.
1980年1月至1983年3月期间，对20例经诱导治疗获得完全缓解的成年急性白血病患者进行了强化治疗效果的研究。强化治疗包括六种联合疗法的循环给药，给药间隔逐渐延长，使用柔红霉素、阿糖胞苷、6-巯基嘌呤和泼尼松龙（DCMP）、环胞苷（DCyMP）、长春新碱（DCVP）、二十二碳酰阿糖胞苷（BHAC-DMP）、阿克拉霉素（BHAC-AMP）和（ACM-MP）。六种联合疗法按顺序给药，间隔一个月，之后分别间隔2、3、4、5个月，最终间隔6个月，直至5年生存期。急性髓系白血病（AML）的中位缓解期为38个月，急性淋巴细胞白血病（ALL）为17个月。AML的中位生存期为66个月，ALL为37个月。五年生存率为50%。20例患者中有9例仍存活。在每次强化治疗的第4天鞘内注射甲氨蝶呤和泼尼松龙以预防中枢神经系统白血病。未发生中枢神经系统白血病。该强化方案被证明对改善成年急性白血病的预后有效。
