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[儿童急性髓细胞白血病:1964年至1979年的治疗结果]

[Acute myelocytic leukemia in childhood: results of treatment from 1964 to 1979].

作者信息

Plüss H J, Hitzig W H

出版信息

Schweiz Med Wochenschr. 1980 Oct 4;110(40):1459-62.

PMID:6944786
Abstract

From 1964 to 1979, 57 children with acute myelocytic leukemia have been treated at the University Children's Hospital, Zürich. The overall remission rate was 0.60, with a median remission duration of 2 months and survival of 6.4 months. Patients with FAB type M 1 responded best, but longtime survivors were observed from all FAB types. Whereas in the 1960s only 4/19 achieved (short) remission, now, since the introduction of cytosine arabinoside, remissions are observed on 79% but median survival (10 months) is still short compared with acute lymphocytic leukemia. However, 11/38 children treated since 1971 survived for more than 2 years. Four of these relapsed (after less than 23 months of complete remission), while of the remaining seven, 5 have been off treatment for 5 to 77 months. This group includes children of both sexes, all ages, low and high WBS's, with organ infiltrates (excluding CNS and skin), and in whom the time taken to achieve M 1 marrow played no role. These results show that, with combination chemotherapy including cytosin arabinoside, remission can almost always be attained, but prolonged remission can be maintained only in about 1/5 of these children. The problems of maintenance treatment and CNS-prophylaxis need more attention in the future.

摘要

1964年至1979年期间,苏黎世大学儿童医院共治疗了57例急性髓细胞白血病患儿。总体缓解率为0.60,缓解期中位数为2个月,生存期为6.4个月。FAB分型为M1型的患者反应最佳,但所有FAB分型均有长期存活者。20世纪60年代只有4/19的患者获得(短期)缓解,而现在,自从引入阿糖胞苷以来,缓解率达到79%,但与急性淋巴细胞白血病相比,中位生存期(10个月)仍然较短。然而,自1971年以来接受治疗的38例患儿中有11例存活超过2年。其中4例复发(完全缓解不到23个月后),其余7例中,5例已停止治疗5至77个月。这组患儿包括不同性别、各年龄段、白细胞计数高低不同、有器官浸润(不包括中枢神经系统和皮肤)的患儿,且达到M1骨髓状态所需时间对此并无影响。这些结果表明,采用包括阿糖胞苷在内的联合化疗,几乎总能实现缓解,但只有约1/5的患儿能够维持长期缓解。维持治疗和中枢神经系统预防问题在未来需要更多关注。

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