改良的德国多中心成年人急性淋巴细胞白血病研究组方案临床应用研究

Clinical study on modified GMALL protocol for adult acute lymphoblastic leukemia

目的分析改良的德国多中心成年人急性淋巴细胞白血病研究组（GMALL）方案治疗成年人急性淋巴细胞白血病（ALL）的疗效和安全性。方法2005年1月至2009年12月共37例新诊断的ALL患者，接受改良的GMALL方案单纯化疗，对其进行回顾性分析，并与同期接受该院常规方案治疗的44例成年ALL患者进行对比分析。结果改良GMALL方案的累积完全缓解（CR）率为89．2％（33／37），1、2、3及4年累积总生存（OS）率分别为77．5％、48．0％、40．0％和40．0％。主要不良反应为3～4级血液学毒性和感染，不良反应易于控制，治疗相关死亡率低。改良GMALL方案组的OS优于该院常规方案组。结论改良的GMALL方案治疗成年人ALL疗效满意，不良反应可以耐受，值得临床推广。

Objective To analyze the treatment efficacy and safety of a modified GMALL protocol for adult acute lymphoblastic leukemia （ALL）. Methods Data of 37 patients with newly diagnosed adult ALL treated with a modified GMALL protocol from January 2005 to December 2009 were retrospectively analyzed, and compared with that of 44 patients treated with an in-house conventional protocol at the same period. Results The complete remission （CR） rate was 89.2 %（33/37） treated with modified GMALL protocol. The cumulative overall survival （OS） rates at 1 year, 2 years, 3 years and 4 years were 77.5 %, 48.0 %, 40.0 % and 40.0 %, respectively. The main adverse events were grade 3 or grade 4 hematological toxicities and infections which were easily managed, and the treatment-related mortality rate was low. The OS of modified GMALL protocol was superior to that of the conventional protocol. Conclusion The modified GMALL protocol has a satisfying effect and the adverse events can be tolerated for adult ALL, so its clinical application can be encouraged.