급성 골수성 백혈병에서 Ara-C, Daunorubicin 화학요법의 치료 효과
Effect of Cytosine Arabinoside and Daunorubicin(AD) Combination Chemotherapy in Acute Myelogenous Leukemia
대한암학회지 1997년 29권 1호 p.160 ~ 170
소속 상세정보
강영숙
정현식/김태석/윤형선/김득조/윤정호/이성광/지현규/남귀현
KMID : 0360319970290010160
Abstract
결론
저자들은 1989년 8월부터 1995년 11월까지 중앙 길병원 내과에서 급성 골수성 백혈병으로
진단 받고 치료가 가능하였던 34명에 대하여 ara-C와 daunorubicin을 사용한 관해 요법을
실시하여 다음과 같은 결과를 얻었다.
1) 34명 중 23명에서 완전 관해에 도달하여 68%의 완전 관해율을 보였으며, 완전관해지속
기간은 4 ∼312+ 주로서 중앙치는 50주였다.
2) 전체환자의 생존기간 중앙치는 62+주였으며, 완전관해에 도달한 환자 중
36%에서 5년 이상의 생존율을 보였다.
3) 총 4예에서 골수 외 조직을 침습한 백혈병이 진단되었는데, M4,
M5a 이외에 M2, M3에서도 각각 1예씩 진단되었
다.
4) 나이, 치료 전 백혈구수, blast의 백분율 등은 예후에 영향을 미치지 않았다.
#초록#
Purpose : Important advances in the treatment of acute myelogenous leukemia have
been made with the introduction of cytosine arabinoside(ara-C) and anthracyclines
(daunorubicin) over the past 20 years. Currently, 60 to 80% of patients with acute
myelogenous leukemia achieve complete remission with induction chemotherapy
consisting of aria-C and daunorubicin(adriamycin) AD('7+3'). The one-fourth of
complete responders will have extended long-term survival and may be cured. Therefore
wetreated patients with acute myelogenous leukemia admitted to our hospital with
AD('7+3') regimen.
Methods : Induction therapy; Thirty four Patients with Previously untreated acute
myelogenous leukemia received AD('7+3') regimen(ara-C, 200 mg/m2/d by
continuous infusion for seven days, and daunorubicin, 45mg/m2/d for 3
days). The second course of therapy was AD('5+2'), if the Patients failed to enter
remission. Consolidation therapy; three cycles of consolidation chemotherapy were
administered with at least 4 week interval following remission. Course 1; ara-C at 100
mg/m2 by subcutaneous injection every 12 hour for seven days,
6-thioguanine at every 12 hour 100 mg/m2 orally every 12 hour for 7
days). Course 2; ara-C(same as course 1) at 100 mg/m2 by subcutaneous
injection every 12 hour for seven days, vincristine at 1.5 mg/m2
(maximum 2 mg) by bolus injection for 1 day, prednisolone at 40
mg/m2(maximum 60 mg) orally for 7 days. Course 3; ara-C(same as
course 1) daunorubicin at 45 mg/m2 by 1 hour infusion for 3 days.
Results : Sixty-eight percent of the 34 patients entered complete remission. The
remission duration for all patients in complete remission ranged from 4 weeks to
3122+ weeks, with the median of 50 weeks. The median duration of
survival in complete responder group was 62 weeks. Twenty-Six percent of patients
with complete remission are alive at 5 years. Cases with extramedullary leukemic
involvement were found in four patients; M2 with orbital mass, M3 and M4 with CNS
leukemia, M5a with subcutaneous nodules. Among the potential prognostic variables
including age, initial WBC count, percent of blast in peripheral blood, none was
statistically related to prognosis.
Conclusion : Combination chemotherapy with cytosine arabinoside and daunorubicin is
a effective regimen for acute myelogenous leukemia as much as other regimen. Further
clinical trials for effective treatment regimen and method are necessary to raise the
complete remission rate.
키워드
Chemotherapy; Aute myelogenous leukemia; AD regimen;
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