DVCLP方案联用粒细胞集落刺激因子对成人急性淋巴细胞白血病诱导缓解治疗的临床研究

A trial of G-CSF combined with DVCLP regimen as the remission induction therapy for adults with acute lymphoblastic Leukemia

目的研究粒细胞集落刺激因子(G-CSF)与DVCLP方案联用治疗初治成人急性淋巴细胞白血病(ALL)的疗效。方法40例患者接受DVCLP方案诱导化疗。随机分为两组:试验组(20例)在化疗前3天至化疗的第7天给予G-CSF;对照组(20例)则在化疗时ANC<1.5×109/L中给予G-CSF。结果患者ANC<1.5×109/L的天数试验组要明显短于对照组[16天±7天,21天±5天(P<0.05)]。完全缓解率、复发率、生存中位数时间、一年生存率试验组依次为85%、22%、11个月、45%;对照组依次为75%、55%、6个月、19%(P>0.05)。结论成人ALL诱导化疗早期应用G-CSF可明显缩短粒细胞减少时间,但对提高完全缓解率、减少复发率和改善长期生存的影响未达到统计学差异。

Objective To evaluate the efficacy of G-CSF combined with DVCLP regimen as the remission induction therapy for adult ALL. Methods Newly diagnosed patients （ n = 40） received DVCLP regimen as the remission induction therapy. In the study group （n = 20）, patients received G-CSF beginning 3 days before the chemotherapy until day 7. In the control group （ n = 20） ,G-CSF was administered only when ANC was 〈 1.5×10^9/L. Results The median time of neutropenia（ ANC 〈 1.5 ×10^9/L） was 16 ＋ 7 days for the study group and 21 ＋Sdays for the control group（P 〈0.05）. The rate of complete remission, relapse rate,the median overall survival and estimated one year survival in the study group are 85%, 22% ,11 months and 45% ;and those numbers in the control group are 75% ,55% ,6 months,and 19% （P 〉 0.05）. Conclusions The use of G-CSF in the early phase of the remission induction therapy for adult ALL can significantly shorten the time of neutropenia. But its positive roles of increasing complete remission rate,decreasing relapse rate and improving the long survival did not reach the statistical difference.