Willemze R, Jager U, Jehn U, Stryckmans P, Bury J, Suciu S, Solbu G, Zittoun R, Burghouts J, Löwenberg B
University Hospital Leiden, The Netherlands.
Eur J Cancer Clin Oncol. 1988 Nov;24(11):1721-5. doi: 10.1016/0277-5379(88)90073-9.
Seventy-nine patients (aged 17-76 years) with acute myelogenous leukemia in first (56) or second (3) relapse, primary refractory leukemia (15) or leukemia occurring as secondary malignancy that developed after a preleukemic phase (3) or after another tumor (2) were given remission induction therapy consisting of cytosine arabinoside (Ara-C, 1 g/m2 as a 2-h infusion every 12 h for 6 days) and m-AMSA (120 mg/m2, i.v. on days 5, 6, 7). In total 45 patients (57%) achieved complete remission. Younger patients and those with a relatively low initial white blood cell count, a good performance status or in first relapse had a higher response rate. Thirty-five patients were given one or two courses of consolidation chemotherapy consisting of Ara-C (3 g/m2 as a 2-h infusion every 12 h for 4 days) and m-AMSA (120 mg/m2 i.v. on day 5). Three patients received an allogeneic bone marrow graft after the induction courses and four patients received an autologous bone marrow transplantation after consolidation therapy. The median of the disease-free survival curve was 21 weeks. The median duration of survival was 25 weeks. The response rate for this intermediate dose Ara-C regimen is satisfactory and does not differ from that reported for high dose Ara-C. The impact of consolidation chemotherapy in bad risk acute myelogenous leukemia is questionable.
79例急性髓性白血病患者（年龄17 - 76岁），处于首次复发（56例）或第二次复发（3例）、原发性难治性白血病（15例），或作为继发性恶性肿瘤出现，在白血病前期（3例）或另一肿瘤后（2例）发生，接受了由阿糖胞苷（Ara - C，1 g/m²，每12小时静脉输注2小时，共6天）和胺苯吖啶（m - AMSA，120 mg/m²，第5、6、7天静脉注射）组成的缓解诱导治疗。总共45例患者（57%）获得完全缓解。较年轻患者以及初始白细胞计数相对较低、体能状态良好或处于首次复发的患者缓解率更高。35例患者接受了一或两个疗程的巩固化疗，由阿糖胞苷（3 g/m²，每12小时静脉输注2小时，共4天）和胺苯吖啶（第5天静脉注射120 mg/m²）组成。3例患者在诱导疗程后接受了异基因骨髓移植，4例患者在巩固治疗后接受了自体骨髓移植。无病生存曲线的中位数为21周。生存时间的中位数为25周。这种中等剂量阿糖胞苷方案的缓解率令人满意，与高剂量阿糖胞苷报道的缓解率无差异。巩固化疗对高危急性髓性白血病的影响值得怀疑。
