Taguchi H, Kinoshita K I, Takatsuki K, Tomonaga M, Araki K, Arima N, Ikeda S, Uozumi K, Kohno H, Kawano F, Kikuchi H, Takahashi H, Tamura K, Chiyoda S, Tsuda H, Nishimura H, Hosokawa T, Matsuzaki H, Momita S, Yamada O, Miyoshi I
Department of Medicine, Kochi Medical School, Japan.
J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Jun 1;12(2):182-6. doi: 10.1097/00042560-199606010-00012.
An intensive combination chemotherapy regimen supported by granulocyte colony-stimulating factor (G-CSF) was evaluated in adult T-cell leukemia/lymphoma (ATLL) patients in a multiinstitutional, cooperative study. Vincristine 1 mg/m2 i.v. day 1, Adriamycin 40 mg/m2 i.v. day 1, cyclophosphamide 400 mg/m2 i.v. day 1, prednisolone 40 mg/m2 i.v. days 1 to 3 and 8 to 10, etoposide 35 mg/m2 i.v. days 1 to 8, vindesine 2 mg/m2 i.v. day 8, ranimustine 50 mg/m2 i.v. day 8, mitoxantrone 7 mg/m2 i.v. day 8, and G-CSF 50 mg/m2 s.c. days 9 to 21 were given for 2 to 4 courses every 3 weeks to 83 patients with ATLL. Complete remission (CR) and partial remission (PR) were achieved in 35.8 and 38.3 percent, respectively, of 81 evaluable patients. The median survival of all patients was 8.5 months, with a predicted 3-year survival of 13.5 percent by the Kaplan-Meier method. The median duration of response was 7.6 months (range 0.2-42.7), and 13 patients were alive. Their median survival time was 29.1 months (range 19.2-44.7). In 67.6 percent of courses, white blood cell (WBC) nadirs were < 1.0 x 10(9)/L. Days required for the recovery of WBC from the nadir to > 1.0 x 10(9)/L were <5 days in 71.4 percent of the treatment courses. The G-CSF supported an intensified chemotherapy regimen for ATLL and yielded better response rate and longer survival compared to previous reports in Japan. Because duration of remission is still short, further studies of postremission therapy or other strategies are warranted.
在一项多机构合作研究中，对成年T细胞白血病/淋巴瘤（ATLL）患者评估了一种由粒细胞集落刺激因子（G-CSF）支持的强化联合化疗方案。长春新碱1mg/m²静脉注射，第1天；阿霉素40mg/m²静脉注射，第1天；环磷酰胺400mg/m²静脉注射，第1天；泼尼松龙40mg/m²静脉注射，第1至3天和第8至10天；依托泊苷35mg/m²静脉注射，第1至8天；长春地辛2mg/m²静脉注射，第8天；司莫司汀50mg/m²静脉注射，第8天；米托蒽醌7mg/m²静脉注射，第8天；G-CSF 50mg/m²皮下注射，第9至21天，每3周给予83例ATLL患者2至4个疗程。81例可评估患者中，完全缓解（CR）和部分缓解（PR）分别达到35.8%和38.3%。所有患者的中位生存期为8.5个月，采用Kaplan-Meier法预测的3年生存率为13.5%。中位缓解持续时间为7.6个月（范围0.2 - 42.7），13例患者存活。他们的中位生存时间为29.1个月（范围19.2 - 44.7）。在67.6%的疗程中，白细胞（WBC）最低点<1.0×10⁹/L。在71.4%的治疗疗程中，WBC从最低点恢复至>1.0×10⁹/L所需天数<5天。与日本之前的报告相比，G-CSF支持的ATLL强化化疗方案产生了更好的缓解率和更长的生存期。由于缓解持续时间仍然较短，有必要对缓解后治疗或其他策略进行进一步研究。
