Curtis J E, Messner H A, Hasselback R, Elhakim T M, McCulloch E A
J Clin Oncol. 1984 Apr;2(4):253-9. doi: 10.1200/JCO.1984.2.4.253.
Three sequential trials of treatment for acute myelogenous leukemia (AML) involving 173 patients were analyzed to identify clinical and myeloblast-cell progenitor properties in culture related to outcome. The latter, including self-renewal capacity expressed as plating efficiency (PE2) and drug sensitivity, were determined for a representative group of 45 patients. Despite increasingly intensive remission induction therapy, similar response rates were achieved in the three trials and no increase in the duration of survival was observed. Clinical attributes at presentation by multivariate analyses were not consistently predictable of outcome. Of the blast cell attributes, only PE2 was predictive of duration of survival (p less than 10(-6)). For patients in remission the relapse rate during the first year was 0.63 compared with 0.15 in subsequent years. The percentage marrow myeloblasts at presentation, a measure of disease activity, was significantly higher for the patients having remissions lasting less than one year. These studies demonstrate the importance of disease-related attributes on the outcome of patients with AML.
对涉及173例急性髓性白血病（AML）患者的三项连续治疗试验进行了分析，以确定与预后相关的临床和培养中的成髓细胞祖细胞特性。对45例代表性患者测定了后者，包括以接种效率（PE2）表示的自我更新能力和药物敏感性。尽管缓解诱导治疗强度不断增加，但三项试验的缓解率相似，且未观察到生存期延长。多变量分析显示，就诊时的临床特征并不能始终如一地预测预后。在原始细胞特征中，只有PE2可预测生存期（p小于10^(-6)）。缓解期患者第一年的复发率为0.63，而随后几年为0.15。就诊时骨髓原始细胞百分比（疾病活动度的一项指标）在缓解期持续不到一年的患者中显著更高。这些研究证明了疾病相关特征对AML患者预后的重要性。
