Borbolla-Escoboza J R, López-Hernández M A, González-Avante M, DeDiego J, Trueba-Christy E, Anaya-Cuéllar I
Servicio de Hematología, Centro Médico Nacional 20 de Noviembre, ISSSTE, México D.F.
Rev Invest Clin. 1998 Jul-Aug;50(4):307-10.
To compare the effectiveness of two chemotherapy regimens for the treatment of relapsed and refractory acute leukemias.
We randomly assigned 24 patients in two groups: the LARR1 group received induction with 4 days of etoposide and 4 days of high-dose ara-C; the LARR2 group received induction therapy with 4 days of etoposide plus 3 days of mitoxantrone. Consolidation was given using the same drugs at the same dosage. Maintenance therapy was the same for both groups alternating methotrexate, vincristine, L-asparaginase, carmustine, cyclophosphamide and Ara-C. Every 15 weeks both groups repeated consolidation according to their group. Granulocyte-colony stimulating factor was used in both groups.
Median survival for both groups was 5 months (range 1-17). Ten months after starting therapy three patients were disease free in the LARR1 group and two in the LARR2 group. There were no statistically significant differences in complete remission rate (p = 0.62), refractoriness (p = 0.58), deaths in induction (0.14) and other parameters.
Our results were comparable with those of others. The only advantage we found was the possibility of using the LARR1 treatment in patients who have reached or are about to reach cardiotoxic-anthracycline doses.
比较两种化疗方案治疗复发和难治性急性白血病的疗效。
我们将24例患者随机分为两组：LARR1组接受依托泊苷4天和大剂量阿糖胞苷4天的诱导治疗；LARR2组接受依托泊苷4天加米托蒽醌3天的诱导治疗。巩固治疗采用相同药物、相同剂量。两组维持治疗相同，交替使用甲氨蝶呤、长春新碱、L-门冬酰胺酶、卡莫司汀、环磷酰胺和阿糖胞苷。每15周两组根据各自分组重复巩固治疗。两组均使用粒细胞集落刺激因子。
两组的中位生存期均为5个月（范围1 - 17个月）。开始治疗10个月后，LARR1组有3例患者无疾病，LARR2组有2例。完全缓解率（p = 0.62）、难治性（p = 0.58）、诱导期死亡（0.14）及其他参数均无统计学显著差异。
我们的结果与其他人的结果相当。我们发现的唯一优势是对于已经达到或即将达到心脏毒性蒽环类药物剂量的患者，可以使用LARR1治疗方案。
