Ruymann F B, Newton W A, Ragab A H, Donaldson M H, Foulkes M
Cancer. 1984 Jan 15;53(2):368-73. doi: 10.1002/1097-0142(19840115)53:2<368::aid-cncr2820530233>3.0.co;2-3.
Thirty children and adolescents with rhabdomyosarcoma (RMS) entered on IRS-1 in a 5-year period had bone marrow metastases (BMM) at diagnosis. BMM at diagnosis occurred in 30/103 patients (29%) with Clinical Group IV RMS. On the average, patients with BMM were older with more extremity primaries than other IRS-1 patients. Alveolar histology was present in 15/30 patients (50%) with BMM, compared to 19% on IRS-1. Eleven patients received vincristine, dactinomycin, cyclophosphamide (VAC), while 19 patients received VAC with Adriamycin (ADR). The overall complete response (CR) rate was 60%. The median disease-free survival times by treatment were 17 weeks with VAC and 32 weeks for VAC + ADR (P greater than 0.10). Relapse from CR in Clinical Group IV patients with BMM occurred in 16/18 patients (89%) and was significantly higher than in 17/29 Clinical Group IV patients (59%) without BMM (P less than 0.035). BMM at diagnosis in children and adolescents with RMS is frequently associated with alveolar histology and is a poor prognostic sign.
在5年期间进入IRS-1研究的30例横纹肌肉瘤（RMS）儿童和青少年在诊断时发生了骨髓转移（BMM）。在临床IV组RMS的103例患者中，有30例（29%）在诊断时出现BMM。平均而言，发生BMM的患者比其他IRS-1患者年龄更大，肢体原发肿瘤更多。30例发生BMM的患者中有15例（50%）为肺泡组织学类型，而在IRS-1研究中该比例为19%。11例患者接受长春新碱、放线菌素D、环磷酰胺（VAC）治疗，19例患者接受VAC联合阿霉素（ADR）治疗。总体完全缓解（CR）率为60%。按治疗方法计算，无病生存时间的中位数VAC组为17周，VAC + ADR组为32周（P大于0.10）。临床IV组发生BMM的患者中，18例有16例（89%）CR后复发，显著高于临床IV组中未发生BMM的29例患者中的17例（59%）（P小于0.035）。RMS儿童和青少年诊断时出现BMM常与肺泡组织学类型相关，是预后不良的征象。
