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目前,急性髓细胞白血病(AML)经诱导缓解后强化治疗,2/3病人可达到CR。由于大量不易被发现的残留白血病细胞的存在,缓解后如果放弃强化治疗,将会导致复发和死亡。所以,降低AML的高复发率和死亡率关键问题是如何进一步治疗。本文总结了6年来6个研究中心248例序贯随机治疗的AML病人。男性131例,女性117例,年龄16～65岁,免疫分型211例,染色体分析212例。 治疗:2个疗程缓解后,病人随机接受2个周期强化治疗(4周期强化组即短组)或6个周期强化(8周强化组即长组)。根据协作组草案:头4个化疗周期两组化疗方案相同,即DAT方案。第一周期DNR50mg/m~2,iv;Ara-c 250mg/m~2第1天,iv,继续100mg,iv,1～9天;硫鸟嘌呤75mg/m~2,Bid,口服,1～9天。60岁以上的Ara-c和TG治疗7天。第二周期同上。若第一周期
At present, acute myeloid leukemia (AML) is intensified after induction of remission, and 2/3 patients can achieve CR. Due to the presence of a large number of residual leukemia cells that are not easily detected, remission and death will result if intensive treatment is abandoned after remission. Therefore, the key issue in reducing the high recurrence rate and mortality of AML is how to treat it further. This article summarizes 248 consecutive AML patients randomized to treatment at 6 centers over 6 years. There were 131 males and 117 females, aged 16-65 years, 211 immunophenotypes and 212 chromosomes. Treatment: After 2 courses of remission, the patients were randomly assigned to receive 2 cycles of intensive treatment (4 cycles of intensive treatment, ie, short treatment) or 6 cycles of intensive treatment (8 weeks of intensive treatment, ie, long treatment). According to the collaboration group draft: The first four chemotherapy cycles have the same two-group chemotherapy regimen, the DAT regimen. The first cycle DNR50mg/m~2,iv; Ara-c 250mg/m~2 Day 1, iv, continue 100mg, iv, 1~9 days; Thioguanine 75mg/m~2, Bid, oral, 1~ 9 days. Ara-c and TG 60 years of age were treated for 7 days. The second cycle is the same as above. If the first cycle