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慢性髓性白血病的治疗。

Treatment of chronic myeloid leukemia.

作者信息

Stryckmans P A

出版信息

Annu Rev Med. 1980;31:159-66. doi: 10.1146/annurev.me.31.020180.001111.

Abstract

Most known chemotherapy agents, used singly, may induce remission of CML. Those that best alleviate symptoms (anemia, splenomegaly, etc) do not change either the Ph' chromosome anomaly in the hemopoietic cells nor the median delay of 3--4 years before fatal blastic transformation. A new goal has recently been formulated in CML therapy, namely complete remission, i.e. disappearance of all signs of leukemia including the Ph' abnormality. This can be achieved in certain cases by the use of aggressive (radio)chemotherapy during the chronic phase of CML. Whether or not it means cure of CML awaits further investigation. Encouraging results with these new therapeutic modalities during the chronic phase, and the possibility of rescuing toxic marrow aplasia by autologous cryopreserved blood stem cells, make it less and less defensible to await CML transformation before using aggressive "eradication" therapy.

摘要

多数已知的化疗药物单独使用时,可能会使慢性粒细胞白血病(CML)获得缓解。那些能最有效地缓解症状(如贫血、脾肿大等)的药物,既不会改变造血细胞中的费城染色体异常,也不会改变在致命的原始细胞转化前平均3至4年的病程。最近在CML治疗中提出了一个新目标,即完全缓解,也就是白血病的所有体征包括费城染色体异常均消失。在CML慢性期使用积极的(放)化疗,在某些情况下可实现这一目标。这是否意味着治愈CML尚有待进一步研究。在慢性期采用这些新治疗方式取得了令人鼓舞的结果,以及利用自体冷冻保存的血液干细胞挽救毒性骨髓再生障碍的可能性,使得在使用积极的“根除”疗法前等待CML转化变得越来越难以自圆其说。

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