Mandelli F, Amadori S, Rajnoldi A C, Di Montezemolo L C, Madon E, Masera G, Meloni G, Pacilli L, Paolucci G, Pastore G, Rosito P, Uderzo C, Vecchi V
Cancer. 1980 Sep 15;46(6):1319-23. doi: 10.1002/1097-0142(19800915)46:6<1319::aid-cncr2820460603>3.0.co;2-x.
The results of discontinuing therapy in children with acute lymphocytic leukemia observed at four associated institutions are presented. Of the 247 patients who achieved complete remission, 122 (49.3%) reached the point of discontinuing therapy after 2-4 years of continuous remission. The median period off therapy was 13 months with a range of 1-69 months. Of the 122 children removed from therapy, 27 (22.1%) relapsed, mainly in the bone marrow; relapses occurred 1-32 months after cessation of therapy (median ten months) with only two relapses occurring later than two years. By actuarial analysis, 57% of the patients are projected in continuous remission after five years from cessation of therapy. Neither selected features at diagnosis nor single modalities of treatment were found to predict whether relapse would occur after discontinuing therapy. Long-term remission and possibly cure can be expected in over one-third of newly diagnosed children with ALL after 2-4 years of antileukemic treatment.
本文展示了在四个相关机构观察到的急性淋巴细胞白血病患儿停止治疗的结果。在247例实现完全缓解的患者中，122例（49.3%）在持续缓解2至4年后达到停止治疗阶段。停止治疗的中位时长为13个月，范围为1至69个月。在122例停止治疗的儿童中，27例（22.1%）复发，主要复发于骨髓；复发发生在停止治疗后的1至32个月（中位时间为10个月），仅有两例复发发生在两年后。通过精算分析，预计57%的患者在停止治疗五年后仍处于持续缓解状态。未发现诊断时的特定特征或单一治疗方式能够预测停止治疗后是否会复发。超过三分之一新诊断的急性淋巴细胞白血病患儿在接受2至4年抗白血病治疗后有望实现长期缓解甚至可能治愈。
