急性淋巴细胞白血病的规范化治疗分析.ppt

* BFM, Berlin-Munster-Frankfurt * MTX, methotrexate; WBC, white blood cell count * Allo SCT, allogeneic stem cell transplant; Auto SCT, autologous stem cell transplant; CIBMTR, Center for International Blood and Marrow Transplant Research; LFS, leukemia free survival; CR, complete remission; MUD, matched unrelated donor * 经常 * * * CNS, central nervous system; CR, complete remission; FAB, French-American-British; LDH, lactic dehydrogenase; MTX, methotrexate * * 30 * * * * ALL, acute lymphocytic leukemia; Hyper-CVAD, modified fractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone; MTX, methotrexate; Ph, Philadelphia chromosome. Our group advocates combining tyrosine kinase inhibitors with chemotherapy in Ph-positive ALL. In this study, we used a lower dose of imatinib, only 2 weeks of each cycle. Later, when we discovered that modified fractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone (hyper-CVAD) was not very myelosuppressive and could be safely combined with imatinib, we started using it continuously throughout the therapy. Once the patients completed the standard backbone hyper?CVAD regimen (alternating cycles of hyper?CVAD and high?dose cytarabine and methotrexate for 8 cycles), they entered a maintenance phase in which they were continuously treated with imatinib and increasing doses of prednisone. In addition, patients received 2 cycles of late and early intensification using the same hyper?CVAD regimen. For more information on this study, go online to: /Oncology/Conference%20Coverage/Hematology%202007/Tracks/ALL%20AML%20APL/Capsules/9.aspx * * * ALL, acute lymphocytic leukemia; Ara-C, cytarabine; COG, Children’s Oncology Group; CT, chemotherapy; HLA, human leukocyte antigen; HSCT, hematopoietic stem cell transplantation; MRD, minimal residual disease; Ph, Philadelphia chromosome. Most ALL regimens used in the adult population were originally developed as pediatric regimens. This study, which introduced imatinib into a p