Foon K A, Smalley R V, Riggs C W, Gale R P
Arch Intern Med. 1983 Sep;143(9):1726-31.
The use of immunotherapy for acute myelogenous leukemia (AML) is controversial. Twenty-four trials have been reported in which 1,491 patients with AML received various forms of immunotherapy, including BCG, methanol extract residue (MER) of BCG, or Corynebacterium parvum. Some patients were immunized with allogeneic or autologous leukemia blast cells. In only four of the 24 trials was a significant prolongation of remission reported. Pooled data from all 24 studies were analyzed further. No statistically significant difference in duration of remission between patients who received maintenance chemotherapy alone and those who received maintenance chemotherapy plus immunotherapy was found. A significant survival advantage for those patients who received BCG and chemotherapy for maintenance therapy was detected. A beneficial biologic effect for the patients treated with BCG is suggested but this was not a disease-free survival advantage, and had no impact on cure of patients with AML. Immunotherapy, as currently conceived, seems to have no substantial benefit for patients with AML receiving optimal chemotherapy.
免疫疗法用于急性髓性白血病（AML）存在争议。已报道了24项试验，其中1491例AML患者接受了各种形式的免疫疗法，包括卡介苗、卡介苗甲醇提取物（MER）或短小棒状杆菌。一些患者用同种异体或自体白血病原始细胞进行免疫。在这24项试验中，只有4项报告了缓解期显著延长。对所有24项研究的汇总数据进行了进一步分析。结果发现，仅接受维持化疗的患者与接受维持化疗加免疫疗法的患者在缓解期持续时间上无统计学显著差异。检测到接受卡介苗和化疗进行维持治疗的患者有显著的生存优势。提示卡介苗治疗的患者有有益的生物学效应，但这并非无病生存优势，对AML患者的治愈也无影响。就目前的认知而言，免疫疗法对接受最佳化疗的AML患者似乎没有实质性益处。
