VDD(P)+M强化诱导治疗成人急性淋巴细胞白血病的临床观察

VDD ( P ) + M intensive induction chemotherapy for adult patients with acute lymphoblastic leukemia.

报告了用VDD(P)+M强化诱导治疗成人急性淋巴细胞白血病(ALL)18例的结果。完全缓解(CR)13例(72％),接受CR后强化巩固和高(中)剂量Ara-C或MTX者,中位持续CR期5.5月,中位生存期21月。主要毒副作用为骨髓造血严重受抑,半数患者并发感染,强调同时强力支持及对症治疗的必要性。

We reported the results of intensive induction chemotherapy in 18 adult patients with acute lymphoblastic leukemia (ALL), including 11 cases of ALL1, 6 of ALL2 and 1 of ALL3. The induction regimen consisted of vincristine, daunorubicin (or adri-amycin), dexamethasone (or prednisone) plus methotrexate intrathecal injection for CNSL prophylaxia (VDD + M protocal). Out of 18 patients, complete remission (CR) was achieved in 13 cases (72%). Median duration of CR is 5. 5 months, median survival of the patients, who received intensive consolidation treatment including high or middle dose cytosine arabinoside as a post remission therapy, is 21 months. The main toxic and side effects were marrow hemopoietic suppression, so that approximately half of patients developed bacteremia or fungemia, but no patient died during the period of induction therapy. It was considered that the VDD(P)+M regimen is effective for treatment of adult patients with ALL, and intensive supporting and symptomatic therapy are required.