COMBINATION CHEMOTHERAPY (RCM PROTOCOL - RESPONSE-ORIENTED CYCLIC MULTIDRUG PROTOCOL) FOR THE ACUTE OR LYMPHOMA TYPE ADULT T-CELL LEUKEMIA

被引:23
作者
UOZUMI, K
HANADA, S
OHNO, N
ISHITSUKA, K
SHIMOTAKAHARA, S
OTSUKA, M
CHYUMAN, Y
NAKAHARA, K
TAKESHITA, T
KUWAZURU, Y
SAITO, T
MAKINO, T
IWAHASHI, M
UTSUNOMIYA, A
ARIMA, T
机构
[1] The Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Kagoshima 890
关键词
COMBINATION CHEMOTHERAPY; RCM PROTOCOL; ACUTE TYPE ATL; LYMPHOMA TYPE ATL;
D O I
10.3109/10428199509059624
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
43 patients with the acute or lymphoma type ATL were treated with the new combination chemotherapy (RCM protocol: response-oriented cyclic multidrug protocol) between January 1989 and December 1991, Complete response (CR) and partial response (PR) were achieved in 20.9% and 65.1% of all treated patients respectively. The median duration of survival was 6.0 months. The survival duration of patients with a high serum lactate dehydrogenase (LDH) value (greater than or equal to 1,000 unit) and/or a poor performance status (PS) (PS 3 or 4) were also improved but not in patients with a severe leukocytosis (greater than or equal to 35,000/mu l). Toxicity was mild (grade 1 or 2) except hematologic toxicity in 4 patients (9.3%) and alopecia in one patient (2.3%). In spite of many patients with a poor PS (PS 3 or 4), our chemotherapeutic results are equal or superior to other previous reports. It seems that response-oriented chemotherapy is suitable for the ATL patients with poor prognostic factors. These results indicate that the RCM protocol is very useful as the first choice chemotherapy for the acute or lymphoma type ATL.
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收藏
页码:317 / 323
页数:7
相关论文
共 33 条
[1]  
Shimoyama M., Ota K., Kikuchi M., Yunoki K., Konda S., Takatsuki K., Ichmaru M., Ogawa M., Kimura I., Tominaga S., Tsugane S., Taguchi H., Minato K., Takenaka T., Tobinai K., Kurita S., Oyama A., Hisano S., Kozuru M., Matsumoto M., Nomura K., Takiguchi T., Sugai S., Yamaguchi K., Hattori T., Kinoshita K., Tajima K., Suemasu K., The Lymphoma Study Group 1981–1983 (1988) Chemotherapeutic results and prognostic factors of patients with advanced non-Hodgkin's lymphoma treated with VEPA or VEPA-M, J.
[2]  
Makino T., Uozumi K., Shimazaki T., Otsuka M., Kuwazuru Y., Saito T., Utsunomiya A., Hanada S., Hashimoto S., Combination Chemotherapy for adult T-cell leukemia (ATL) using Cyclophosphamide, Vindesine, and Prednisolone (CV'P), J. Jpn. Soc. Cancer Ther., 23, pp. 2657-2662, (1988)
[3]  
Nomura K., Matsumoto M., Clinical features of adult T-cell leukemia in Kagoshima, the southernmost district in Japan—comparison with T-cell lymphoma-, Acta Haematologica Japonica, 44, pp. 11457-14464, (1981)
[4]  
Shimamoto Y., Suga K., Shimojo M., Nishimura J., Nawata H., Yamaguchi M., Comparison of CHOP versus VEPA therapy in patients with lymphoma type of adult T-cell leukemia, Leuk. Lymph., 2, pp. 335-340, (1990)
[5]  
Lofters W., Campbell M., Gibbs W.N., Cheson B.D., 2′-Deoxycoformycin therapy in adult T-cell leukemia/lymphoma, Cancer, 60, pp. 2605-2608, (1987)
[6]  
Waldmann T.A., Goldman C.K., Bongiovanni K.F., Sharrow S.O., Davey M.P., Cease K.B., Greenberg S.J., Longo D.L., Therapy of patients with human T-cell lymphotrophic virus I-induced adult T-cell leukemia with anti-Tac, a monoclonal antibody to the receptor for interleukin-2, Blood, 72, pp. 1805-1806, (1988)
[7]  
Edelson R., Berger C., Gasparro F., Jagasothy B., Heald P., Wintroub B., Vonderheid E., Knobler R., Wolff K., Plewig G., McKiernan G., Christiansen I., Oster M., Honigsmann H., Wilford H., Kokoschka E., Rehle T., Perez M., Stingl G., Laroche L., Treatment of cutaneous T-cell lymphoma by extracorporeal photochemotherapy. Preliminary results, New Engl, J. Med., 316, pp. 297-303, (1987)
[8]  
Shimoyama M., Members of The Lymphoma Study Group (1984–87). 1991 Diagnostic criteria and classification of clinical subtypes of adult T-cell leukaemia-lymphoma
[9]  
a report from the lymphoma study group (1984–87), Brit, J. Haematol., 79, pp. 428-437
[10]  
Uchiyama T., Yodoi J., Sagawa K., Takatsuki K., Uchino H., Adult T-cell leukemia: Clinical and hematologic features of 16 cases, Blood, 50, pp. 481-492, (1977)