Bassan R, Battista R, Corneo G, Rossi G, Lambertenghi-Deliliers G, Viero P, Rambaldi A, D'Emilio A, Neonato M G, Pogliani E
Divisione di Ematologia Ospedali Riuniti, Bergamo, Italy.
Leuk Lymphoma. 1993 Sep;11(1-2):105-10. doi: 10.3109/10428199309054736.
Fifty two adults (aged 15 to 66 years) with newly diagnosed acute lymphoblastic leukemia (ALL, n = 47) or lymphoid blast phase chronic myelogenous leukemia (Ly-CML, n = 5) were managed with three distinct protocols containing idarubicin at a cumulative dose of 36, 20, and 10 mg/m2, respectively, plus vincristine, L-asparaginase, and prednisolone (IVAP-1, -2, -3). IVAP-1 was highly toxic and gave a low complete remission (CR) rate (7/17, 41%). Nine patients died of complications while severely neutropenic, and one had resistant disease. In contrast, 24 of 28 patients subsequently treated with IVAP-2 achieved a CR (86%, p 0.005), the rate of both hematological and extrahematological toxicity being significantly reduced compared with IVAP-1 (p < 0.05). With IVAP-3, 6/7 patients aged > 60 years achieved CR. IVAP-2 with total idarubicin 20 mg/m2 is a very effective and well tolerated regimen for the initial treatment of adults with ALL.
52名新诊断的急性淋巴细胞白血病（ALL，n = 47）或淋巴细胞母细胞期慢性粒细胞白血病（Ly-CML，n = 5）的成年人（年龄15至66岁）采用三种不同方案进行治疗，分别含累积剂量为36、20和10 mg/m²的伊达比星，加长春新碱、L-天冬酰胺酶和泼尼松龙（IVAP-1、-2、-3）。IVAP-1毒性很大，完全缓解（CR）率低（7/17，41%）。9例患者在严重中性粒细胞减少时死于并发症，1例有耐药性疾病。相比之下，随后接受IVAP-2治疗的28例患者中有24例达到CR（86%，p 0.005），血液学和血液外毒性发生率与IVAP-1相比均显著降低（p < 0.05）。采用IVAP-3，6/7例年龄>60岁的患者达到CR。总伊达比星剂量为20 mg/m²的IVAP-2是成人ALL初始治疗非常有效且耐受性良好的方案。
