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作者对1981年1月～1989年12月来自DanaFather 肿瘤研究所和波士顿儿童医院434例急性淋巴细胞白血病(ALL)病儿进行了骨髓细胞遗传学、治疗及预后分析评价。其中1981年1月～1985年5月治疗分析165例,1985年7月～1987年12月治疗分析136例,1987年1月～1989年12月治疗分析133例。1985年～1987年的治疗与1981年～1985年的治疗方案不同。(1)第一天治疗是增加单剂量Coli 埃希氏杆菌属(E Coli)天门冬酰胺酶,(2)诱导治疗仅用甲氨蝶呤(MTX)40mg/m~2,(3)对高危性(WBC 20～100×10~9/L)病儿诱导缓解期间增加第二次阿霉素治疗,(4)高危性病儿减少颅脑照射剂量为2400cGY,(5)婴儿或WBC>100×19~9/L 病儿诱导缓解后即增加1个月的大剂量MTX 和大剂量阿糖胞苷(Ara-C)治疗,(6)增加了对中枢神经系统(CNS)鞘内注射Ara-C 治疗。1987年～1989年的治疗是(1)于治疗第一天随机给予E Coil、Erwinia 或
The authors evaluated bone marrow cytogenetics, treatment, and prognosis in 434 children with acute lymphoblastic leukemia (ALL) from the DanaFather Oncology Institute and Boston Children’s Hospital from January 1981 to December 1989. Among them, 165 cases were analyzed from January 1981 to May 1985, 136 cases were analyzed from July 1985 to December 1987, and 133 cases were analyzed from January 1987 to December 1989. The treatment from 1985 to 1987 was different from the treatment from 1981 to 1985. (1) The first day of treatment was the addition of a single dose of Coli asparaginase, (2) induction therapy with methotrexate (MTX) only 40 mg / m 2, (3) High-risk (WBC 20 ~ 100 × 10 ~ 9 / L) increased risk of second adriamycin treatment during remission induction; (4) high risk children reduce brain irradiation dose of 2400cGY, (5) infant or WBC> 100 × 19 ~ 9 / L sick children after induction of remission increased by 1 month of high-dose MTX and high-dose cytarabine (Ara-C) treatment, (6) increased the central nervous system (CNS) intrathecal injection of Ara -C treatment. Treatment from 1987 to 1989 was (1) randomized to E Coil, Erwinia or