Korean J Hematol 1997; 32(3):

Published online September 30, 1997

© The Korean Society of Hematology

성인 급성 림프구성 백혈병에서 강화된 관해유도요법의 치료효과

석준호, 이경희, 현명수

영남대학교 의과대학 내과학교실

Effect of Treatment with Intensified Induction Regimen in Adult Acute Lymphocytic Leukemia

Jun Ho Seok, Kyung Hee Lee, Myung Soo Hyun

Department of Internal Medicine, College of Medine, Yeungnam University, Taegu, Korea

Abstract

Background: Adult acute lymphocytic leukemia(ALL) is a hematologic malignant disease characterized by an uncontrolled proliferation of immature lymphocytes and their progenitors. Progress in the treatment of adults with ALL has been more difficult to achieve, and until recently there was general agreement that adults have lower
remission rates, briefer duration of remissions, and shorter survival times than that of children receiving identical treatment.
Methods: Twenty one patients with ALL were treated with remission induction chemotherapy consisting of vincristine, prednisolone, daunorubicin and L-asparaginase.
After successful remission induction, consolidation-intensification and maintenance therapy, CNS prophylaxis were done.
Results:
1) The overall complete remission(CR) rate was 66.7%(14/21). The median remission duration for the 14 patients with CR was 16 months(3∼31 months) and the median
overall survival time was 11 months(1∼35 months). The 3-year relapse free survival rate was 14.3% and the median time to complete remission was 41 days(18∼71 days).
The median overall survival time of complete remission group was 31.8 months and non-response group was 1.4 months.
2) Five(23.8%) Patients died during the induction therapy Period and two Patients did not respond to treatment.
3) Six out of fourteen patients(42.9%) who had achieved remission relapsed and the sites of relapse were the bone marrow(66.7%) and CNS(16.7%).
4) Fourteen patients(66.7%, 14/21) died during follow-up period. The main causes of death were infection in eight cases(57.1%) and hemorrage in two(14.3%).
5) Favorable factors influencing the remission rate were initial response to chemotherapy and sex(P=0.031), and factor influencing survival time was complete
remission(P=0.005).
Conclusion: This induction regimen was thought to be effective in remission rate, but it has considerable number of side effects and the shortness of the remission duration. In the future, more intensified induction and consolidation chemotherapy should be considered.

Keywords Acute lymphocytic leukemia; Intensified induction therapy; Survival;

Article

Korean J Hematol 1997; 32(3): 376-387

Published online September 30, 1997

Copyright © The Korean Society of Hematology.

성인 급성 림프구성 백혈병에서 강화된 관해유도요법의 치료효과

석준호, 이경희, 현명수

영남대학교 의과대학 내과학교실

Effect of Treatment with Intensified Induction Regimen in Adult Acute Lymphocytic Leukemia

Jun Ho Seok, Kyung Hee Lee, Myung Soo Hyun

Department of Internal Medicine, College of Medine, Yeungnam University, Taegu, Korea

Abstract

Background: Adult acute lymphocytic leukemia(ALL) is a hematologic malignant disease characterized by an uncontrolled proliferation of immature lymphocytes and their progenitors. Progress in the treatment of adults with ALL has been more difficult to achieve, and until recently there was general agreement that adults have lower
remission rates, briefer duration of remissions, and shorter survival times than that of children receiving identical treatment.
Methods: Twenty one patients with ALL were treated with remission induction chemotherapy consisting of vincristine, prednisolone, daunorubicin and L-asparaginase.
After successful remission induction, consolidation-intensification and maintenance therapy, CNS prophylaxis were done.
Results:
1) The overall complete remission(CR) rate was 66.7%(14/21). The median remission duration for the 14 patients with CR was 16 months(3∼31 months) and the median
overall survival time was 11 months(1∼35 months). The 3-year relapse free survival rate was 14.3% and the median time to complete remission was 41 days(18∼71 days).
The median overall survival time of complete remission group was 31.8 months and non-response group was 1.4 months.
2) Five(23.8%) Patients died during the induction therapy Period and two Patients did not respond to treatment.
3) Six out of fourteen patients(42.9%) who had achieved remission relapsed and the sites of relapse were the bone marrow(66.7%) and CNS(16.7%).
4) Fourteen patients(66.7%, 14/21) died during follow-up period. The main causes of death were infection in eight cases(57.1%) and hemorrage in two(14.3%).
5) Favorable factors influencing the remission rate were initial response to chemotherapy and sex(P=0.031), and factor influencing survival time was complete
remission(P=0.005).
Conclusion: This induction regimen was thought to be effective in remission rate, but it has considerable number of side effects and the shortness of the remission duration. In the future, more intensified induction and consolidation chemotherapy should be considered.

Keywords: Acute lymphocytic leukemia, Intensified induction therapy, Survival,

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