Abdulkadyrov K M, Bessmel'tzev S S, Rukavitzyn O A, Shilova E R, Shcherbakova E G
Vopr Onkol. 1997;43(3):284-9.
The evidence on the treatment of 146 cases of blastic (myeloid-101, lymphoblastic-45) crisis (BC) have been analyzed to evaluate the efficacy of different schemes of polychemotherapy (PCT) administered for blastic crisis myeloid leukemia (CML). The study of the 7 + 3, 7 + 3 + B. RP, VRP, RAP, VAP, CROMP. COP + Rub schemes as well as large doses of cytosar showed the 7 + 3 and RAP to be the most effective for myeloid BC and COP + Rub and VAP-for lymphoblastic one. Complete clinico-hematologic remission was 55 and 56%, respectively, in myeloid BC and 50 and 57%, respectively, in lymphoblastic BC. Relatively lower antitumor effect was recorded for the CROMP and RP in myeloid and the VRP in lymphoblastic crisis. Actuarial survival was assessed both for the entire CML group and each type of crisis and PCT scheme, and it was shown that more cases of lymphoblastic BC survived while fewer of them survive 3-5 years. However, 6-year survival rates were identical in both groups. Survival in the 7 + 3 group appeared to be higher than that in the VRP group suffering from lymphoblastic. BC. To summarize, the 7 + 3 and RAP schemes proved the most effective treatment for myeloid BC, while the COP + Rub and VAP for lymphoblastic BC.
对146例急变期(髓系101例,淋系45例)危象(BC)的治疗证据进行了分析,以评估用于髓系白血病急变期(CML)的不同多药化疗(PCT)方案的疗效。对7 + 3、7 + 3 + B.RP、VRP、RAP、VAP、CROMP、COP + Rub方案以及大剂量阿糖胞苷的研究表明,7 + 3和RAP方案对髓系BC最有效,而COP + Rub和VAP方案对淋系BC最有效。髓系BC的完全临床血液学缓解率分别为55%和56%,淋系BC分别为50%和57%。在髓系急变期,CROMP和RP方案的抗肿瘤效果相对较低,在淋系急变期,VRP方案的抗肿瘤效果相对较低。对整个CML组以及每种急变期类型和PCT方案评估了精算生存率,结果显示,淋系BC存活的病例更多,但3 - 5年存活的病例较少。然而,两组的6年生存率相同。在淋系BC患者中,7 + 3组的生存率似乎高于VRP组。总之,7 + 3和RAP方案被证明是治疗髓系BC最有效的方案,而COP + Rub和VAP方案是治疗淋系BC最有效的方案。