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[成人急性淋巴细胞白血病和急性未分化白血病治疗的患者招募及初步研究结果]

[Recruiting patients and results of a preliminary study on the therapy of acute lymphatic leukemia and acute undifferentiated leukemia in adults].

作者信息

Hoelzer D, Thiel E, Löffler H, Bodenstein H, Plaumann L, Büchner T, Urbanitz D, Koch P, Heimpel H, Engelhardt R

出版信息

Onkologie. 1983 Aug;6(4):170-4. doi: 10.1159/000215227.

Abstract

The aim of the study was to improve remission quality through application of an intensified induction therapy successful in childhood ALL; in a modified form for patients of 15-35 years and in a reduced form for patients of greater than 35-65 years with ALL or AUL. The 8-week induction therapy consists of two phases. In phase I, prednisone, vincristine, daunorubicin, and L-asparaginase are given and in phase II, cyclophosphamide, cytosine-arabinoside, and 6-mercaptopurinee. As CNS-prophylaxis, intrathecal methotrexate, and CNS-irradiation with 24 Gy are used. After 3 months a re-induction therapy similar to the induction therapy is given with dexamethasone and adriamycin instead of prednisone and daunorubicin and without L-asparaginase. Maintenance therapy with 6-mercaptopurin and methotrexate follows over a period of 2 years. Since the formation of the study group in 1979 up to 30.06.81, 170 patients from 25 hospitals with newly diagnosed ALL or AUL were treated according to the protocol. Up to 30.11.81, 162 patients had completed treatment and were evaluable. Of these, 77.8% achieved complete remission, 80.7% in the age group 15-35 years and 68.3% in the age group greater than 35-65 years. The median survival time for all patients was 24 months and for the 126 patients with complete remission the median has not yet been reached (last observation 31 months). The median remission duration is 20 months. Prognostic factors for remission duration are (1) the number of chemotherapy courses required to reach complete remission, (2) the immunological subtype, (3) age and (4) initial leukocyte count.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

该研究的目的是通过应用一种在儿童急性淋巴细胞白血病(ALL)中成功的强化诱导疗法来提高缓解质量;该疗法以改良形式用于15至35岁的患者,以简化形式用于年龄大于35至65岁的ALL或急性未分化白血病(AUL)患者。为期8周的诱导疗法包括两个阶段。在第一阶段,给予泼尼松、长春新碱、柔红霉素和L-天冬酰胺酶,在第二阶段,给予环磷酰胺、阿糖胞苷和6-巯基嘌呤。作为中枢神经系统预防措施,使用鞘内注射甲氨蝶呤和24 Gy的中枢神经系统照射。3个月后,给予与诱导疗法相似的再诱导疗法,用 dexamethasone和阿霉素代替泼尼松和柔红霉素,且不使用L-天冬酰胺酶。随后进行为期2年的6-巯基嘌呤和甲氨蝶呤维持治疗。自1979年研究组组建至1981年6月30日,来自25家医院的170例新诊断的ALL或AUL患者按照该方案接受了治疗。至1981年11月30日,162例患者完成治疗并可进行评估。其中,77.8%实现了完全缓解,15至35岁年龄组为80.7%,大于35至65岁年龄组为68.3%。所有患者的中位生存时间为24个月,126例完全缓解患者的中位生存时间尚未达到(最后一次观察为31个月)。中位缓解持续时间为20个月。缓解持续时间的预后因素包括:(1)达到完全缓解所需的化疗疗程数;(2)免疫亚型;(3)年龄;(4)初始白细胞计数。(摘要截选至250字)

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