【摘要】 目的:比较成人急性淋巴细胞白血病(ALL)患者不同诱导化疗方案治疗的疗效。方法:回顾性分析医科院血液病医院从1998年6月—2008年1月新诊断、治疗的ALL患者124例。采用SPSS13.0统计学软件分析有关数据。结果:①根据诱导治疗方案分为VDCLP、VDCP2组,2组的1疗程CR率为87.9%和84.5%,总CR为93.9%和89.7%。VDCLP组中位无病生存(DFS)21(0～116)个月,中位总生存(OS)23(2～117)个月;VDCP组中位DFS10(0～109)个月,中位OS14(1～110)个月。2组的3年DFS分别为55.2%和19.2%。2组的3年OS率56.2%和21.1%,(P<0.05)。②≤30岁的青少年和年轻成人ALL采用VDCLP和VDCP方案1疗程CR率分别为92.7%和86.8%,总CR率分别为97.6%和94.7%。VDCLP组中位DFS23(0～116)个月,中位OS24(2～117)个月;VDCP组中位DFS10(0～109)个月、中位OS14(1～110)个月。2组的3年DFS分别为60.4%和18.2%。2组的3年OS率62.9%和20.9%。③采用VDCLP方案诱导治疗的染色体核型标危组成人ALL,VDCLP组中位DFS22(0～116)个月、中位OS24(3～117)个月;VDCP方案诱导治疗中位DFS13(0～109)个月、中位OS19(1～110)个月。2组的3年DFS分别为59.0%和DFS23.3%。2组的3年OS率60.7%和29.8%。而染色体核型高危成人ALL,VDCLP组中位DFS6(0～32)个月,中位OS17(2～38)个月;VDCP组中位DFS8(0～20)个月,中位OS10(5～23)个月。2组的3年DFS分别为0.0%和DFS0.0%。2组的3年OS率0.0%和0.0%。结论:诱导治疗中加L-Asp对CR率无明显影响,但诱导治疗采用VDCLP较VDCP可以提高成人ALL的DFS和OS。更多还原

【Abstract】 Objective:To compare responses in the patients with adult acute lymphoblastic leukemia(ALL)to different induction chemotherapy regimens.Method:124 patients with newly diagnosed ALL treated at Institute of Hematology & Blood Diseases Hospital,Chinese Academy of Medical Science & Peking Union Medical College from August 1998 to January 2008 were retrospectively evaluated and data was analyzed with the statistical software of SPSS13.0.Result:①The patients were divided into two groups,named VDCLP and VDCP,based on the regimens they underwent.Complete remission(CR)rates for the two groups after one cycle of chemotherapy were 87.9% and 84.5%,and the total CR for the two groups were 93.9% and 89.7%,respectively.In VDCLP group,median disease free survival(DFS)was 21(0～116)months and median overall survival(OS)was 23(2～117)months.Median DFS and OS of VDCP group were 10(0-109)months and 14(1～110)months respectively.Three years DFS was 55.2% and 19.2% for the two groups respectively,and three years OS for them were 56.2% and 21.1% respectively.②For adolescents and young adults(≤30 years),CR rates were 92.7% and 86.8% respectively in VDCLP group and VDCP group after 1 cycle,the total CR rates were 97.6% and 94.6% respectively.Median DFS was 23(0～116)months and 10(0～109)months,median OS 24(2～117)months and 14(1～110).months for the two groups respectively.Three-year DFS were 60.4% and 18.2%,OS were 62.9% and 20.9% respectively for VDCLP and VDCP groups.③According to karyotype analysis,for patients with the standard-risk karyotypes,three-year DFS were 59.9% and 23.3% for VDCLP and VDCP groups,three-year OS were 60.7%和29.8%;for patients with high-risk karyotypes,three-year DFS and OS for the two groups were all 0%.Conclusion:Addition of L-Asp to the induction chemotherapy did not affect CR rate,but could improve the survival.更多还原