期刊文献+

序贯诱导法治疗高危急性非淋巴细胞白血病 被引量:2

Treatment to high-risk acute non-lymphocytic leukemia with sequential induction
原文传递
导出
摘要 目的探讨小剂量HA(LD—HA)方案及标准方案序贯诱导法治疗高危急性非淋巴细胞白血病(ANLL)的疗效。方法对50例不适合常规诱导的高危ANLL患者(LD—HA组)进行了序贯诱导。第1个周期诱导方案为LD.HA,首次诱导仍未缓解者,更换为标准方案(DA或HA)诱导。选择同期以DA或HA方案诱导治疗的23例ANLL患者(DA/HA组)作为对照,最多诱导2个周期。结果LD.HA组患者完全缓解率为80.0%(40/50),诱导过程死亡2例;中位无瘤生存时间为19.6个月,中位生存时间为12.2个月;1、3、5年生存率分别为57.0%、24.1%、18.8%。DA/HA组共17例完全缓解,缓解率为73.9%;中位无瘤生存时间为19.8个月,中位生存时间为12.1个月;1、3、5年生存率分别为56.58%、27.1%、27.1%,两组相比,1、3、5年生存率差异无统计学意义(Х^2值分别为0.009、0.237、1.807,P值均〉0.05)。结论以LD—HA及标准方案序贯诱导高危ANLL患者,可获得较高的完全缓解率及长期生存率。 Objective To investigate the outcome of high-risk acute non-lymphocytic leukemia treated with sequential low-dose cytarabine and harringtonine(LD-HA) and standard induction. Methods 50 high-risk ANLL patients (LD-HA group) who were regarded as unfit for intensive chemotherapy were chosen to receive LD-HA. Reinductive treatments with standard regimens would be given for those who did not achieve complete remission. 23 patients DA/HA group given two cycles of standard inductive regimens were taken as the control. Results In LD-HA group 80.0 % (40/50) reached CR, 2 patients died shortly after inductive therapy. The median leukemia-free survival(LFS) was 19.6 months, and the median overall survival (OS) was 12.2 months. Overall survival was 57.0 % at 1 year, 24.1% at $ years, and 18.8 % at 5 years. While the CR rate was 73.9 % for DA/HA group, and none died during the inductive therapy. LFS and OS was 19.8 months and 12.1 months, respectively. OS rate was 56.58 % at 1 year, 27.1% at 3 years, and 27.1% at 5 years. There were no difference on OS rates between 2 groups (Х^2 were 0.009, 0.237 and 1.807, respectively, P 〉0.05). Conclusion In patients who were unfit for intensive chemotherapy, sequential therapy with LD-HA and standard induction improved the rate of complete remission and the duration of survival.
出处 《白血病.淋巴瘤》 CAS 2011年第3期147-150,共4页 Journal of Leukemia & Lymphoma
关键词 白血病 非淋巴细胞 急性 序贯诱导 抗肿瘤联合化疗方案 治疗结果 Leukemia, non-lymphocytic, acute Sequencial induction Antineoplastic combined chemotherapy protocols Treatment outcome
  • 引文网络
  • 相关文献

参考文献8

  • 1Burnett AK, Milligan D, Prentice AG, et al. A comparison of low-dose cytarabine and hydroxyurea with or without all-trans retinoic acid for acute myeloid leukemia and high-risk myelodysplastic syndrome in patients not considered fit for intensive treatment. Cancer, 2007, 109: 1114-1124.
  • 2Huang CL, Deng ML, Guo R J, et al. A study on the induction of differentiation of human leukemic ceils by harringtonine combined with cytarabine. Leukemia, 1988, 2:518-522.
  • 3Kantarjian HM, Talpaz M, Santini V, et al. Homoharringtonine: history, current research, and future direction. Cancer, 2001, 92: 1591-1605.
  • 4Boyd AW, Sullivan JR. Leukemic cell differentiation in vivo and in vitro: arrest of proliferation parallels the differentiation induced by the antileukemic drug Harringtonine. Blood, 1984, 63: 384-392.
  • 5Latagliata R, Breccia M, Pulsoni A, et al. Acute myeloblastic leukemia secondary to myelodysplasia (MDS-AML): a comparison of remission induction with three drugs versus standard two-drugs induction. Leuk Lymphoma, 2000, 36: 539-541.
  • 6Rizzieri DA, O'Brien JA, Broadwater G, et al.Outcomes of patients who undergo aggressive induction therapy for secondary acute myeloid leukemia. Cancer, 2009, 115: 2922-2929.
  • 7Fernandez HF, Sun Z, Yao X, et al. Anthracycline dose intensification in acute myeloid leukemia. N EngI J Med, 2009, 361: 1249-1259.
  • 8Mayer R J, Davis RB, Schiffer CA, et al. Intensive postremission chemotherapy in adults with acute myeloid leukemia. Cancer and Leukemia Group B. N Engl J Med, 1994, 331: 896-903.

同被引文献15

  • 1FENAUX P,CASTAIGNE S,DOMBRET H,et al.All-tranvS retinoic acid followed by intensive chemo-therapy gives a high complete remission rate and mayprolong remissions in newly diagnosed acute promye-locytic leukemia:a pilot study on 26 cases[J]. Blood,1992,80:2176-2181.
  • 2MUINDI J,FRANKEL S R, MILLER WH Jr,et al.Continuous treatment with all-trans retinoic acid cau-ses a progressive reduction in plasma drug concentra-tions: implications for relap'se and retinoid “ resist-ance” in patients with acute promyelocytic leukemia[J]. Blood,1992,79:299-303.
  • 3HUANG C UDENG M L,GUO R J,et al. A studyon the induction of differentiation of human leukemiccelLs by harringtonine combined with cytarabine[J].Leukemia, 1988,2:518 — 522.
  • 4FENAUX P,CASTAIGNE S,CHOMIENNE C,et al.All tranvS retinoic acid treatment for patients with a-cute promyelocytic leukemia [ J ]. Leukemia, 1992,6Suppl 1 :64 — 66.
  • 5SANZ M A,LO COCO F, MARTIN G,et al. Defini-tion of relapse risk and role of nonanthracycline drugsfor consolidation in patients with acute promyelocyticleukemia: A joint study of the PETHEMA andG1MEMA cooperative groups [J]. Blood, 2000 , 96:1247-1253.
  • 6PARK J H,QIAO B,PANAGEAS K S,et al. Earlydeath rate in acute promyelocytic leukemia remainshigh despite all-trans retinoic acid [ J]. Blood, 2011,118:1248—1254.
  • 7MONTESINOS P,BERGUA J M,VEILENGA E,etal. Differentiation syndrome in patients with acutepromyelocytic leukemia treated with all-trans retinoicacid and anthracycline chemotherapy: characteristics,outcome,and prognostic factors[J]. Blood,2009,113 :775-783.
  • 8梁英民.佟瑞芝,黄昌亮.三尖杉酯碱与阿糖胞苷在诱导HL-60细胞分化中的协同作用[J].中华血液学杂志,1992,13(3):144-144.
  • 9CHEN G Q,SHEN Z X,WU F,et al. Pharmacokinet-ics and efficacy of low-dose all-trans retinoic acid inthe treatment of acute promyeocytic leukemia [J].Leukemia, 1996,10 :825 — 828.
  • 10ADES L,CHEVRET S,DE BOTTON S,et al. Out-come of acute promyelocytic leukemia treated with alltrans retinoic acid and chemotherapy in elderly pa-tients: the European group experience [J]. Leukemia.2005,19:230-233.

引证文献2

二级引证文献14

;
使用帮助 返回顶部