Jehn U, Heinemann V
Department of Internal Medicine, Hematology/Oncology, Klinikum Grosshadern, University of Munich, Germany.
Ann Hematol. 1993 Mar;66(3):131-4. doi: 10.1007/BF01697622.
Twenty-five consecutive leukemia patients (21 AML, 4 ALL) with either primary resistance (n = 22) or resistant relapse (n = 3) of all FAB subtypes were treated with 1 or 2 cycles of ID-ara C (1 g/m2 i.v. q 12 h, days 1-6) and AMSA (120 mg/m2 i.v., days 5-7). Patients reaching CR received 1 cycle of intensive consolidation using ara C 3 g/m2 i.v. q 12 h, days 1-4 and AMSA 120 mg/m2 i.v., day 5. Two patients received an allograft thereafter and are still alive and in CCR. CR was achieved in 12/25 patients (48%), ten after 1 cycle of induction and two after 2 cycles; 10/22 patients with primary resistant disease reached CR, and 2/3 with resistant relapse. Nine patients remained refractory (36%) and four died during hypoplasia (16%). Median DFS of the 12 responders was 2.9 months, median survival from time of CR 8.9 months. Median overall survival of responders and nonresponders was 6 months from time of resistance. Survival advantage of responding patients (n = 12) as compared with nonresponders (n = 13) was 10.7 vs. 3.2 months (p = 0.002). Toxicity of chemotherapy was acceptable: one patient experienced pulmonary edema due to ara C; two patients developed life-threatening systemic fungal infections, one of whom died while in CR.
连续25例白血病患者（21例急性髓细胞白血病，4例急性淋巴细胞白血病），所有FAB亚型均存在原发性耐药（n = 22）或耐药复发（n = 3），接受1或2个周期的去氧肋间型阿糖胞苷（ID - ara C，1 g/m²静脉注射，每12小时1次，第1 - 6天）和安吖啶（AMSA，120 mg/m²静脉注射，第5 - 7天）治疗。达到完全缓解（CR）的患者接受1个周期的强化巩固治疗，使用阿糖胞苷3 g/m²静脉注射，每12小时1次，第1 - 4天，以及安吖啶120 mg/m²静脉注射，第5天。此后2例患者接受了同种异体移植，目前仍存活且处于持续完全缓解状态。25例患者中有12例（48%）达到CR，10例在1个周期诱导治疗后达到，2例在2个周期后达到；22例原发性耐药疾病患者中有10例达到CR，3例耐药复发患者中有2例达到CR。9例患者仍难治（36%），4例在造血功能低下期间死亡（16%）。12例缓解者的中位无病生存期为2.9个月，从CR时间算起的中位生存期为8.9个月。缓解者和未缓解者从耐药时间算起的中位总生存期均为6个月。缓解患者（n = 12）与未缓解患者（n = 13）的生存优势分别为10.7个月和3.2个月（p = 0.002）。化疗毒性可接受：1例患者因阿糖胞苷出现肺水肿；2例患者发生危及生命的系统性真菌感染，其中1例在CR时死亡。
