Preisler H D
Department of Hematologic Oncology, Roswell Park Memorial Institute, Buffalo, New York 14263.
Blood Rev. 1987 Jun;1(2):97-105. doi: 10.1016/0268-960x(87)90003-8.
The treatment of acute nonlymphocytic leukemia involves a two stage approach. During the first stage, remission induction, cytotoxic drugs are administered to return hematopoiesis to normal. During the second stage, therapy is administered in an attempt to prolong the duration of remission. The clinical approaches and the problems incurred during these stages are not identical. At the time of diagnosis a decision must be made regarding whether or not the patient is likely to benefit from chemotherapy. If the answer is in the affirmative, then a decision must be made regarding the appropriate chemotherapeutic regimen. The optimal approach for the treatment of patients appears to vary depending on the age of the patient and whether or not there is a history of toxic exposure in the past. Overall remission rates vary from 40% to 85% depending upon the age of the patient and the patient's past history. Patients whose leukemia is induced into complete remission benefit from therapy administered after complete remission is attained. The optimal therapy, however, has not as yet been clearly defined. Conventional maintenance therapy appears to provide little benefit. On the other hand, the more intensive therapies are associated with substantial risk to the patient. The role of these modalities in the treatment of older patients is currently under investigation.
急性非淋巴细胞白血病的治疗采用两阶段方法。在第一阶段，即缓解诱导阶段，给予细胞毒性药物以使造血功能恢复正常。在第二阶段，进行治疗以试图延长缓解期。这些阶段的临床方法和所产生的问题并不相同。在诊断时，必须决定患者是否可能从化疗中获益。如果答案是肯定的，那么必须决定合适的化疗方案。治疗患者的最佳方法似乎因患者年龄以及过去是否有接触毒物的病史而异。总体缓解率根据患者年龄和既往病史在40%至85%之间变化。白血病诱导进入完全缓解的患者在达到完全缓解后接受治疗会受益。然而，最佳治疗方法尚未明确界定。传统的维持治疗似乎益处不大。另一方面，更强化的治疗对患者有很大风险。这些治疗方式在老年患者治疗中的作用目前正在研究中。
