吕跃教授研究组治疗急性淋巴细胞白血病获得成功

    吕跃教授研究组应用具有世界先进水平的治疗方法治疗急性淋巴细胞白血病获得成功，该成果已经发表在世界著名的国际血液杂志上(Int J Hematol. 2011 Aug;94(2):163-8)，为急性淋巴细胞白血病患者带来新的希望和福音。中山大学附属肿瘤医院血液肿瘤科吕跃

    英文摘要

Induction therapy using the MRC UKALLXII/ECOG E2993 protocol in Chinese adults with acute lymphoblastic leukemia

Hua Wang • Xiao-Qin Chen • Qi-Rong Geng •
Pan-Pan Liu • Gui-Nan Lin • Zhong-Jun Xia •
Yue Lu（通讯作者）

Abstract

Patients with newly diagnosed acute lymphoblastic
leukemia (ALL) at a single institution were analyzed
retrospectively. From 2006 to 2010, 47 patients were treated
using the MRC UKALLXII/ECOG E2993 protocol. Prior to
July 2005, 40 patients had been treated with the JALSG ALL
87 protocol. A complete remission (CR) rate of 91.5% was
achieved with the E2993 protocol, which was not significantly
higher than the 80% achieved using JALSG
(P[0.05). The median duration of CR in months was 19 for
all patients treated with the MRC UKALLXII/ECOG E2993
protocol. Ph? patients showed a median CR duration of
11.5 months, while Ph- patients had a significantly longer
CR duration of 19 months (P = 0.019). Further, Phpatients
at standard risk (stratified on the basis of age and
white blood cell count at diagnosis) had a CR duration of
21 months, which was significantly longer than the
12-month CR duration for the ten Ph- patients at high risk
(P = 0.001). Significant differences were found in the
2-year event-free survival and overall survival rates between
the MRC UKALLXII/ECOG E2993 and JALSG ALL 87
groups in the following three cohorts: all patients (P = 0.009

and 0.022, respectively), Ph- patients (P = 0.009 and
0.018, respectively), and standard-risk patients (P = 0.014
and 0.007, respectively). The overall mortality rate for
induction therapy in the MRC UKALLXII/ECOG E2993
group was 2.1% (1 of 47 patients). One or more instances of
grade IV myelosuppression occurred during induction therapy.
Among the non-hematological toxicities, alopecia and
elevated ALT and AST levels were the most common. The
levels of ALT and AST could be reduced to less than twofold
the normal values within 1?2 weeks. The data indicate that
the MRC UKALLXII/ECOG E2993 regimen is well tolerated
in Chinese adults with ALL and can improve survival
compared with the JALSG ALL 87 protocol. Risk stratification
at diagnosis based on age and WBC count is suitable
for adults with ALL, and it is necessary to adopt different
strategies as determined by diagnostic results. Lastly, Ph?
patients have an extremely poor prognosis.
Keywords Acute lymphoblastic leukemia  Adults 
Induction therapy  MRC UKALLXII/ECOG E2993
protocol

Int J Hematol. 2011 Aug;94(2):163-8.