Champlin R E, Gajewski J L, Golde D W
Division of Hematology/Oncology, UCLA School of Medicine 90024.
Semin Oncol. 1989 Feb;16(1):51-6.
Current data indicate that most elderly patients with acute myelogenous leukemia should be treated with intensive chemotherapy. Most should receive remission induction chemotherapy using cytarabine 100 to 200 mg/m2/d by constant intravenous infusion for five to seven days plus daunorubicin greater than or equal to 30 mg/m2/d for three days. Patients in good overall condition with a near-normal performance status may benefit from a more intensive regimen. Patients achieving remission should receive one to three courses of consolidation chemotherapy. Highly debilitated patients have poor results with any form of therapy, and there has been no apparent advantage for low-dose chemotherapy compared to standard treatment regimens. The intensity of chemotherapy treatment must be individualized to the requirements of the patient.
目前的数据表明,大多数老年急性髓系白血病患者应接受强化化疗。大多数患者应接受缓解诱导化疗,使用阿糖胞苷100至200mg/m²/天持续静脉输注5至7天,加柔红霉素≥30mg/m²/天,共3天。总体状况良好、体能状态接近正常的患者可能从更强化的方案中获益。达到缓解的患者应接受1至3个疗程的巩固化疗。身体极度虚弱的患者接受任何形式的治疗效果都很差,与标准治疗方案相比,低剂量化疗没有明显优势。化疗治疗的强度必须根据患者的需求个体化。