成人急性淋巴细胞白血病治疗.ppt

* 成人急性淋巴细胞白血病的治疗 ALL化学治疗 诱导治疗 自发缓解 VCR + Pred（VP）诱导， CR 36 – 67% VCR + DNR + Pred （VDP）诱导，CR 70 – 85% VCR + DNR + L-Asp + Pred （VDLP）— 缓解期延长 VCR + DNR + CTX + Pred （VDCP） 缓解后治疗 T-ALL ：大剂量CTX冲击 + Ara-C 成熟B-ALL：短疗程诱导及强化治疗 中枢系统白血病的预防及治疗 Remission Induction Regimens And Postremission Therapy for ALL No. of CNS Survival Reference patients Induction Consolidation Maintenance Prophylaxis CR% Med(mo) Blood 368 V, P, D, Cy, Dex, V, Dox, Cy 6-MP, MTX MTX, XRT 74 28 71:123, 1988 Ara-c, 6-MP Ara-C, TG Blood 168 V, P, Dox, Cy Ara-C, MTX, TG V, P, Dox, 6-MP MTX 68 18 73:87, 1989 V, P, A, Cy MTX, ActD, Cy BCNU Blood 109 V, P, A, D V, P, A, D 6-MP, MTX MTX, XRT 88 28 78:2814, 1991 Ara-c, VM26, MTX Leukemia 541 V, P, D, A V, P, Mito; 6-MP, MTX MTX 80 NR 6:182, 1992 ? Cy V, Dex, MTX; VM26, Ara-C Blood 197 V, P, A, D, Cy Cy, Ara-c, 6-MP, V 6-MP, MTX MTX, XRT 85 36 85:78:2814, 1995 A, Dox, Dex, TG V, P Blood 128 Cy, V, Dox, Dex MTX, Ara-C 6-MP, MTX, V, P MTX, Ara-C 91 36 86:173a, 1995 Group Year n (pts) Age* Induction Consolidation Maintenance CR LFS