Marty M, Ganem G, Fischer J, Flandrin G, Berger R, Schaison G, Degos L, Boiron M
Nouv Rev Fr Hematol (1978). 1984;26(6):371-8.
A retrospective study of 119 patients with acute promyelocytic leukemia (APL) treated with similar DNR containing regimens in reported. Antecedent of radiation exposure or cancer was found in 10 patients. At presentation hyperleucocytosis was rare (13/119 greater than 30 000/microliter); variant form was identified in 5 cases. Organomegaly was uncommon and severe metabolic abnormality was never noted at presentation. DIC was observed in 75% of pts; t (15;17) was confirmed in 25/30 pts. Complete remission (CR) rates have increased from 43% to 76% on account of improvement of supportive therapy with adequate DIC management. Addition of ARA C did not improve CR rates (72%). Surprisingly duration of CR seems related to maintenance therapy as 11/26 pts receiving 6 MP-MTX maintenance regimen were long-term survivors as compared to 1/34 comparable pts receiving cyclic monthly courses of chemotherapy.
一项回顾性研究报告了119例接受含柔红霉素类似方案治疗的急性早幼粒细胞白血病(APL)患者。10例患者有辐射暴露或癌症病史。就诊时高白细胞血症罕见(119例中有13例超过30000/微升);5例发现有变异型。器官肿大不常见,就诊时从未发现严重代谢异常。75%的患者观察到弥散性血管内凝血(DIC);30例患者中有25例证实存在t(15;17)。由于支持治疗的改善和适当的DIC管理,完全缓解(CR)率从43%提高到了76%。添加阿糖胞苷(ARA C)并未提高CR率(72%)。令人惊讶的是,CR持续时间似乎与维持治疗有关,因为接受6巯基嘌呤-甲氨蝶呤(6 MP-MTX)维持方案的26例患者中有11例是长期幸存者,而接受每月周期性化疗疗程的34例可比患者中只有1例。