Fière D, Archimbaud E, Extra J M, Marty M, David B, Witz F, Sotto J J, Rochant H, Gastaut J A, Le Prise P Y
Haematol Blood Transfus. 1987;30:125-9. doi: 10.1007/978-3-642-71213-5_19.
We present here the results of a cooperative trial in 244 adult patients with acute lymphoblastic leukemia. Induction therapy with vincristine, cytoxan, and prednisone (VCP) gave the same complete remission rate after one course as more aggressive induction with vincristine, rubidazone, araC, and prednisone (VRAP) due to increased toxic death in the aggressive arm. Because of high efficacy of salvage therapy with VRAP regimen in patients failing to achieve CR with VCP regimen, patients initially randomized to receive VCP had a significantly higher CR rate than patients initially receiving VRAP (87% vs. 73%, p = 0.01). Patients randomized to receive postremission consolidation using adriamycin, araC, and asparaginase (AAA) prior to maintenance had a significantly longer remission than patients not receiving consolidation (p less than 0.005). At the time of analysis allogeneic bone marrow transplantation does not significantly increase disease-free survival when compared with intensive consolidation chemotherapy.
我们在此展示了一项针对244例成年急性淋巴细胞白血病患者的合作试验结果。使用长春新碱、环磷酰胺和泼尼松（VCP）进行诱导治疗，一个疗程后的完全缓解率与使用长春新碱、柔红霉素、阿糖胞苷和泼尼松（VRAP）进行更积极的诱导治疗相同，因为积极治疗组的毒性死亡增加。由于VRAP方案在VCP方案治疗未达到完全缓解的患者中挽救治疗效果显著，最初随机接受VCP治疗的患者完全缓解率显著高于最初接受VRAP治疗的患者（87%对73%，p = 0.01）。随机接受在维持治疗前使用阿霉素、阿糖胞苷和天冬酰胺酶（AAA）进行缓解后巩固治疗的患者，其缓解期明显长于未接受巩固治疗的患者（p小于0.005）。在分析时，与强化巩固化疗相比，异基因骨髓移植并未显著提高无病生存率。
