急性白血病の治療

～特に6-MPと併用するステロイドホルモンの投与量の問題～

抄録

The material consists of 140 patients with AML who were registered from July 1, 1959 to November 30, 1963, Only those who presented themselves without receiving any treatment were included. They were divided into two age groups, i. e., children group (below 15 years) and adults group (15 years or over). One of therapeutic schedules was chosen by opening a sealed envelope containing the schedule to be applied, i. e., the small dosage of Prednisolone 0.5mg/kg/day (Aa) or the large dosage of Prednisolone 2mg/kg, 'day (Ab), in association with an ordinary dosage of 6-MP, i. e., 2-3mg/kg/day. The schedule was continued 4-8 weeks till a remission was acquired or toxic manifestations prevented further administration. Results: In children, remissions were acquired in 52.49 (11/21) in the Aa and in 55.0% (11/20) in the Ab. The total remission rate in children was 53.7% (22/41). In adults, remissions were gained in 28.6% (14/49) of the Aa and in 20.0% (10/50) of the Ab. The total remission rate in adults was 24.3% (24/99), Thus lower rates of remission were noted in large dosage of Prednisolone in adults, but the difference are not statistically significant. The numbers of survived at 8 weeks after start of treatments were compared. In children, the survival rates were 61.9% in the Aa and in 65.0% in the Ab in both dosage groups, while in adults it was 42.8% in the Aa and 34.9% in the Ab. Among steroidhormones, Prednisolone “Takeda” was used in the first half period and Dexamethasone (Orgadrone with Prednisolone equivalent dosage) was used in the second half. No significant differences in the remission rate and survival rate were found between these two drugs.
Conclusion: From our experience of 140 cases of AML, it was concluded that the large lose of Prednisolone or of Dexamethasone should not be administered to all patients without preselection.