Vaughan W P, Karp J E, Burke P J
Blood. 1984 Nov;64(5):975-80.
Based on a series of clinical and laboratory studies of leukemia cell kinetics and responses to chemotherapy, we have developed an intensive timed-sequential regimen of daunorubicin and high-dose infusion 1-beta-D-arabinofuranosyl cytosine for the treatment of adult acute nonlymphocytic leukemia. Of the first 34 patients achieving complete remission (CR) with a single cycle of this therapy, four (12%) remain in complete remission without further therapy after a minimum of five years of follow-up. Treatment of relapsed patients with a second course of the same regimen at relapse and no chemotherapy in second remission increased to seven (21%) the number of patients expected to remain in remission for four years or more from their last chemotherapy. Beginning in 1980, however, we gave all consenting adults a second cycle of this chemotherapy in early first remission. Of the first 25 patients treated with a second cycle of this chemotherapy in early first remission, there was one toxic death, but 11 patients (44%) remain in CR with a median follow-up of almost three years.
基于一系列关于白血病细胞动力学及化疗反应的临床和实验室研究，我们制定了一种强化的定时序贯方案，使用柔红霉素和大剂量输注1-β-D-阿拉伯呋喃糖基胞嘧啶来治疗成人急性非淋巴细胞白血病。在首批34例通过单周期该疗法实现完全缓解（CR）的患者中，经过至少五年的随访，有4例（12%）在未接受进一步治疗的情况下仍处于完全缓解状态。对于复发患者，在复发时采用相同方案进行第二个疗程治疗，且第二次缓解期不进行化疗，使得预计从最后一次化疗起能保持四年或更长时间缓解的患者人数增加到了7例（21%）。然而，从1980年开始，我们让所有同意的成年患者在首次缓解早期接受该化疗的第二个周期。在首批25例于首次缓解早期接受该化疗第二个周期治疗的患者中，有1例死于毒性反应，但11例患者（44%）仍处于完全缓解状态，中位随访时间近三年。
