Hitchcock-Bryan S, Gelber R, Cassady J R, Sallan S E
Med Pediatr Oncol. 1986;14(4):211-5. doi: 10.1002/mpo.2950140405.
Early intensive therapy might be critical in improving failure-free survival for children with acute lymphoblastic leukemia. Between 1973 and 1977, 107 children received vincristine and prednisone (VP) induction and 30 received the same two agents plus an anthracycline (VPA). Ninety-nine of the VP-treated group and all 30 of the VPA-treated patients achieved complete remission. At a median observation time of 10 years, 59 of 137 children remain in continuous complete remission. Failure-free survival was 37% for the VP group and 63% for the VPA group (p = 0.02). Failure-free survival for boys who received VP was 28%, compared with 68% for boys who received VPA (p = 0.007). All 11 extramedullary relapses and all seven relapses occurring beyond 3.8 years from diagnosis (three testicular and four bone marrow) were observed among the VP group. We conclude that use of an anthracycline during remission induction therapy influenced failure-free survival and that early results of successful antileukemic therapy in children must be confirmed by follow-up progress reports.
早期强化治疗对于提高急性淋巴细胞白血病患儿的无失败生存率可能至关重要。1973年至1977年期间，107名儿童接受了长春新碱和泼尼松（VP）诱导治疗，30名儿童接受了相同的两种药物加一种蒽环类药物（VPA）治疗。VP治疗组的99名儿童和所有30名VPA治疗的患者均实现了完全缓解。在中位观察时间为10年时，137名儿童中有59名仍处于持续完全缓解状态。VP组的无失败生存率为37%，VPA组为63%（p = 0.02）。接受VP治疗的男孩的无失败生存率为28%，而接受VPA治疗的男孩为68%（p = 0.007）。VP组观察到所有11例髓外复发以及所有7例在诊断后3.8年以上发生的复发（3例睾丸复发和4例骨髓复发）。我们得出结论，在缓解诱导治疗期间使用蒽环类药物影响了无失败生存率，并且儿童成功抗白血病治疗的早期结果必须通过后续进展报告来证实。
