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初诊时的细胞遗传学改变是急性髓细胞白血病(AML)的重要预后因素之一。但先前的研究或因病例数少或治疗方案不一致导致在评价某特异染色体的预后意义时结论相互矛盾。医学研究委员会(MRC)AML10试验则为估价初诊时染色体异常作为独立的预后因素提供了较合适的研究对象,因为受试者所接受的诱导和巩固治疗方案相当。 材料和方法 自1988～1995年,有1966例病人进入MRCAML10试验,包括364名儿童(<15岁)和1602名成人(大多数不超过55岁)。其中原发AML1797例,继发AML141例,其余28例因后来发现不是AML而退出。1612名病人成功地进行了核型分析。病人随机接受两疗程的DAT(DNR、Ara-C、6-TG)或ADE(Ara-C、DNR、VP16)诱导治疗。第3、4疗程的巩固化疗方案分别是MACE(A-msa、Ara-c、VP_(16))和MIDAC(MTZ、
The cytogenetic change at the time of initial diagnosis is one of the important prognostic factors of acute myeloid leukemia (AML). However, previous studies either conflicted with the number of cases or inconsistent treatment options leading to the evaluation of the prognostic significance of a specific chromosome. The Medical Research Council (MRC) AML10 trial provided a more appropriate target for valuing chromosomal abnormalities at the time of initial diagnosis as an independent prognostic factor because the subjects received the same induction and consolidation regimens. Materials and Methods From 1988 to 1995, 1966 patients entered the MRCAML10 trial, including 364 children (<15 years of age) and 1,602 adults (most of them not exceeding 55 years of age). The primary AML was 1797 cases, followed by AML 141 cases, and the remaining 28 cases were withdrawn because they were later found not to be AML. 1612 patients successfully performed karyotype analysis. Patients were randomized to receive two courses of DAT (DNR, Ara-C, 6-TG) or ADE (Ara-C, DNR, VP16) induction therapy. The third and fourth courses of consolidation chemotherapy were MACE (A-msa, Ara-c, VP_(16)) and MIDAC (MTZ, respectively).