Rohatiner A Z, Gregory W M, Bassan R, Barnett M J, Waxman J, Richards M A, Ganesan T S, Tucker J, Malik S T, Biruls R
Department of Medical Oncology, St. Bartholomew's Hospital, London, England.
J Clin Oncol. 1988 Feb;6(2):218-26. doi: 10.1200/JCO.1988.6.2.218.
Since 1978, 187 patients (age range, 15 to 59, median 44 years) have received short-term chemotherapy as part of three sequential open studies (B-IX, X, Xb) or a randomized clinical trial (B-XI). An intended six cycles of Adriamycin (ADR) (doxorubicin; Adria Laboratories, Columbus, OH), cytarabine (ara-C), and thioguanine (TG) were administered with as short an intercycle time as possible. No further therapy was administered. Complete remission (CR) was achieved in 118 of 187 patients (63%). On univariate and multivariate analyses achievement of CR correlated adversely with a low serum albumin at presentation and an antecedent marrow disorder. Forty-five patients continue in first remission between 15 months and 8 1/2 years, no relapses being seen after 3 1/2 years (median follow-up, 3 1/2 years). The median duration of remission was 1 year. M3 morphology, a blast count less than 100 x 10(9)/L, and absence of hepatosplenomegaly correlated favorably with remission duration. There was no difference in duration of remission between patients receiving 3, 4, 5, or 6 cycles. The best results overall were achieved in patients under the age of 40, with 43% projected to remain free of disease at 5 years. Fifty patients remain alive between 17 months and 9 years, the predicted actuarial survival being 25% at 5 years.
自1978年以来，187例患者（年龄范围为15至59岁，中位年龄44岁）作为三项连续的开放性研究（B-IX、X、Xb）或一项随机临床试验（B-XI）的一部分接受了短期化疗。计划给予六个周期的阿霉素（ADR）（多柔比星；阿德里亚实验室，俄亥俄州哥伦布市）、阿糖胞苷（ara-C）和硫鸟嘌呤（TG），并尽可能缩短周期间时间。未给予进一步治疗。187例患者中有118例（63%）实现了完全缓解（CR）。单因素和多因素分析显示，CR的实现与就诊时低血清白蛋白和既往骨髓疾病呈负相关。45例患者在15个月至8年半的时间内持续处于首次缓解状态，3年半后未见复发（中位随访时间为3年半）。缓解的中位持续时间为1年。M3形态、原始细胞计数低于100×10⁹/L以及无肝脾肿大与缓解持续时间呈正相关。接受3、4、5或6个周期治疗的患者在缓解持续时间上没有差异。总体而言，40岁以下患者取得了最佳结果，预计5年无病生存率为43%。50例患者在17个月至9年之间存活，预计5年精算生存率为25%。
