Stryckmans P, Delforge A, Bron D, Malarme M, Debusscher L, Suciu S, Ronge-Collard E
Blood Cells. 1982;8(3):603-22.
The factors which are thought to determine the response of acute leukemia (AL) to therapy are: 1) tumor size 2) drug dose 3) sensitivity to drug, 4) scheduling of drugs and 5) suppression of normal hemopoiesis. Each of these factors is considered in terms of the scientific data supporting their importance. Inability to measure the size of the tumor mass during all phases of treated AL continues to weaken rational strategies for therapy especially maintenance chemotherapy. Increasing the drug dose improves cell kill and potentially the cure rate up to the limits of toxicity. These limits may be extended by bone marrow transplantation. Various systems to study the drug sensitivity of leukemic cells are in experimental use, including stem cell assays but as yet they do not give a guide to altering therapy. The scheduling of multiple drugs is designed to increase cell kill by recruitment into the cycle, but "sanctuaries" appear to exist for resting cells. The suppression of normal hemopoiesis apparently due to leukemia-associated inhibitors is associated with favorable prognosis in childhood ALL but use of this information to improve treatment protocols is still unclear.
被认为决定急性白血病（AL）对治疗反应的因素有：1）肿瘤大小；2）药物剂量；3）对药物的敏感性；4）药物给药方案；5）对正常造血功能的抑制。根据支持这些因素重要性的科学数据对每一项进行了考量。在接受治疗的急性白血病各阶段无法测量肿瘤块大小，这继续削弱了尤其是维持化疗的合理治疗策略。增加药物剂量可提高细胞杀伤率，并在毒性极限范围内有可能提高治愈率。通过骨髓移植可扩大这些极限。多种用于研究白血病细胞药物敏感性的系统正在实验中使用，包括干细胞检测，但目前它们尚不能为改变治疗提供指导。多种药物的给药方案旨在通过使细胞进入细胞周期来增加细胞杀伤，但静止细胞似乎存在“庇护所”。正常造血功能的抑制显然归因于白血病相关抑制剂，这与儿童急性淋巴细胞白血病的良好预后相关，但利用这一信息改进治疗方案仍不明确。
