Department of Hematology, School of Medicine, Karadeniz Technical University, Trabzon,
Department of Internal Medicine, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Chemotherapy. 2018;63(4):207-213. doi: 10.1159/000492531. Epub 2018 Oct 10.
Although cure rates in pediatric acute lymphoblastic leukemia (ALL) are quite high with combined chemotherapy regimens, complete response (CR) and long-term survival rates in adults are 80-90 and 30-40%, respectively. Currently, combined chemotherapy regimens, such as Hyper-CVAD and PETHEMA, are used in patients with adult ALL. However, there has been no study comparing the results of Hyper-CVAD and PETHEMA ALL-93.
In this retrospective single-center study, we evaluated the results of Hyper-CVAD and PETHEMA ALL-93 in 51 ALL patients treated between September 2008 and March 2017 at the Department of Hematology, Faculty of Medicine, Karadeniz Technical University.
Thirty-eight patients were treated with Hyper-CVAD and 13 with PETHEMA ALL-93. CR was obtained in 90 and 100% of patients, respectively. Survival estimates were comparable between Hyper-CVAD and PE-THEMA ALL-93, with a median overall survival (OS) and a median disease-free survival (DFS) of 17.5 and 12.1 months, respectively, for Hyper-CVAD and of 18.6 and 12.9 months, respectively, for PETHEMA ALL-93. The 2-year OS rates for Hyper-CVAD and PETHEMA ALL-93 were 30 and 40%, respectively, and the 2-year DFS rates were 28 and 44%, respectively. PETHEMA ALL-93 resulted in more hepatotoxicity, hypofibrinogenemia, aspergillus infection, and skin rash than Hyper-CVAD.
Although Hyper-CVAD and PE-THEMA ALL-93 showed similar effects, Hyper-CVAD was tolerated better. Age and comorbidities should be taken into account before a chemotherapy regimen is determined for patients with ALL.
尽管联合化疗方案可使小儿急性淋巴细胞白血病（ALL）的治愈率相当高，但成人 ALL 的完全缓解（CR）率和长期生存率分别为 80-90%和 30-40%。目前，成人 ALL 患者使用 Hyper-CVAD 和 PETHEMA 等联合化疗方案。然而，尚无研究比较 Hyper-CVAD 和 PETHEMA ALL-93 的结果。
在这项回顾性单中心研究中，我们评估了 2008 年 9 月至 2017 年 3 月在卡拉德尼兹技术大学医学院血液科接受治疗的 51 例 ALL 患者的 Hyper-CVAD 和 PETHEMA ALL-93 结果。
38 例患者接受 Hyper-CVAD 治疗，13 例患者接受 PETHEMA ALL-93 治疗。患者的 CR 率分别为 90%和 100%。Hyper-CVAD 和 PETHEMA ALL-93 的生存估计值相似，Hyper-CVAD 的中位总生存期（OS）和中位无病生存期（DFS）分别为 17.5 个月和 12.1 个月，PETHEMA ALL-93 的中位 OS 和 DFS 分别为 18.6 个月和 12.9 个月。Hyper-CVAD 和 PETHEMA ALL-93 的 2 年 OS 率分别为 30%和 40%，2 年 DFS 率分别为 28%和 44%。与 Hyper-CVAD 相比，PETHEMA ALL-93 导致更多的肝毒性、低纤维蛋白原血症、曲霉菌感染和皮疹。
尽管 Hyper-CVAD 和 PETHEMA ALL-93 显示出相似的效果，但 Hyper-CVAD 的耐受性更好。在确定 ALL 患者的化疗方案之前，应考虑年龄和合并症。
