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在急性髓细胞白血病(AML)的治疗中,诱导治疗强度对长期生存的影响尚无严格的研究。在明显骨髓抑制时是否要继续强烈治疗,这种强化导致的骨髓抑制是否会使全血细胞减少的时间更加延长是研究者面临的棘手问题。为此,儿童癌症研究组进行了这项前瞻性随机研究。 作者将1989年10月至1993年5月间经血象及骨髓活检证实的儿童和21岁以下青少年AML589例随机分成强化时机组(295例)和标准时机组(294例)。两组均用DCTER方案诱导治疗(地塞米松6mg/m~2·d,口服;6-硫代鸟嘌呤100mg/m~2·d,口服;阿糖胞苷200mg/m~2·d;足叶乙甙100mg/m~2·d及柔红霉素20mg/m~2·d,连续静滴。0～4天给药,同时鞘内注阿糖
In the treatment of acute myeloid leukemia (AML), there is no rigorous study of the effect of induction therapy on long-term survival. In the obvious bone marrow suppression whether to continue intensive treatment, the strengthening of the resulting bone marrow suppression will make the pancytopenia more prolonged researchers are facing the thorny problem. To this end, the Children’s Cancer Research Group conducted this prospective randomized study. The authors randomized 508 children with AML confirmed by blood and bone marrow biopsy between October 1989 and May 1993 and adolescents under 21 years of age to 295 cases of intensive-time patients and 294 patients with standard-risk patients. Both groups were treated with DCTER (dexamethasone 6mg / m ~ 2 · d, orally; 6-thioguanine 100mg / m ~ 2 · d, oral; cytarabine 200mg / m ~ 2 · d; Etoposide 100mg / m ~ 2 · d and daunorubicin 20mg / m ~ 2 · d, continuous intravenous infusion of 0 to 4 days, while intrathecal injection of sugar