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蒽环类是高效抗肿瘤药物,是治疗急性髓系白血病最有效药物的一类;柔红霉素和阿霉素是最常用的蒽环类药物。过去的15年中出现了明确的用药模式:柔红霉素用于髓系白血病,特别是急性髓系白血病;阿霉素用于淋巴系白血病如急性淋巴细胞白血病、淋巴瘤和实体瘤。这种模式产生的原因不很清楚,几乎没有对照试验的直接比较,这促使我们回顾一下在急性髓系白血病治疗中的资料:是支持应用柔红霉素还是支持应用阿霉素。急性髓系白血病治疗中,几乎没有柔红霉素与阿霉素的对照研究;在一项前瞻性随机的CALGB研究中,653例成年人或用阿糖胞苷加柔红霉素(30或45mg/m~2/天×3天)或用阿糖胞苷加阿霉素(30mg/m~2/天×3天)进行诱导缓解。60岁以下的病人中,柔红霉素45mg/m~2治疗组的缓解率(72%)高于柔红霉
Anthracyclines are highly effective antitumor drugs and are the most effective drugs for the treatment of acute myeloid leukemia; daunorubicin and doxorubicin are the most commonly used anthracyclines. The definitive mode of administration has occurred in the past 15 years: daunorubicin is used in myeloid leukemias, especially acute myeloid leukemia; and adriamycin is used in lymphoid leukemias such as acute lymphoblastic leukemia, lymphoma, and solid tumors. The reason for this pattern is not very clear, and there is almost no direct comparison of controlled trials, which prompted us to review the data in the treatment of acute myeloid leukemia: whether it supports the application of daunorubicin or doxorubicin. In the treatment of acute myeloid leukemia, there is almost no control study of daunorubicin and doxorubicin; in a prospective randomized CALGB study, 653 adults or with cytarabine plus daunorubicin (30 or 45 mg/m~2/day x 3 days) or induced remission with cytarabine plus doxorubicin (30 mg/m~2/day x 3 days). Among patients under 60 years of age, the remission rate (72%) of the daunorubicin 45 mg/m~2 treatment group was higher than that of the red yeast