成人急性淋巴细胞白血病。62例患者根据临床表现对治疗的反应。

Adult acute lymphoblastic leukemia. Response to therapy according to presenting features in 62 patients.

作者信息

Lazzarino M, Morra E, Alessandrino E P, Canevari A, Salvaneschi L, Castelli G, Brusamolino E, Pagnucco G, Isernia P, Orlandi E, Zei G, Bernasconi C

出版信息

Eur J Cancer Clin Oncol. 1982 Sep;18(9):813-9. doi: 10.1016/0277-5379(82)90190-0.

DOI:10.1016/0277-5379(82)90190-0

PMID:6961037

Abstract

Sixty-two adult patients with acute lymphoblastic leukemia (ALL) were treated with an induction regimen including vincristine, daunorubicin and prednisone (VDP) followed by CNS prophylaxis. Forty-five patients (72.5%) achieved complete remission (CR). The CR were maintained with daily 6-MP and weekly MTX. Monthly reinduction cycles with vincristine and prednisone (plus daunorubicin every three courses) were also given. Median duration of CR was 10.4 months. Overall survival was 17.4 months. The remission rate and length of CR were studied in relation to the clinical and hematological features present at diagnosis. CR rate was adversely influenced by age only over 40 and by tumoral presentation. The length of remission was negatively influenced by tumoral presentation, CNS involvement, high circulating blast count, L2 and L3 cytology, and T or B immunological phenotype. Multiple regression analysis confirmed the weight of FAB morphology in determining the length of remission. Among L2 adult patients, tumoral presentation appears to be the major unfavourable prognostic factor.

摘要

62例成年急性淋巴细胞白血病（ALL）患者接受了包含长春新碱、柔红霉素和泼尼松（VDP）的诱导方案治疗，随后进行中枢神经系统预防。45例患者（72.5%）达到完全缓解（CR）。通过每日使用6-巯基嘌呤（6-MP）和每周使用甲氨蝶呤（MTX）维持CR。还给予了每月一次的长春新碱和泼尼松再诱导周期（每三个疗程加用柔红霉素）。CR的中位持续时间为10.4个月。总生存期为17.4个月。研究了缓解率和CR时长与诊断时存在的临床和血液学特征的关系。CR率仅受到40岁以上年龄和肿瘤表现的不利影响。缓解时长受到肿瘤表现、中枢神经系统受累、循环原始细胞计数高、L2和L3细胞学以及T或B免疫表型的负面影响。多元回归分析证实了FAB形态学在确定缓解时长方面的重要性。在L2成年患者中，肿瘤表现似乎是主要的不良预后因素。