急性白血病寛解導入療法に関する研究
第1編 NCMP two step療法による成人急性非リンパ性白血病の寛解導入に関する検討
キーワード:
急性白血病・化学療法
1981 年 93 巻 1-2 号 p. 1-13
詳細
1981 年 93 巻 1-2 号 p. 1-13
The clinical effectiveness of a new protocol, the NCMP (N: neocarzinostatin C: cytosine arabinoside M: 6-mercaptopurine P: prednisolone) two-step regimen was studied in 19 patients with acute non-lymphocytic leukemia (ANLL). All patients were previously untreated and ages ranged from 15 to 75 y. o. (median: 54 y. o.). The ratio of male to female was 11 to 8. The doses and administration-routes of antileukemic agents were: N, 1, 400 u/m2/day, was administrated by i. v. drip on day 1, 2, 3 and 4 (Regimen 1) and N, 4, 000 u/m2/day, i. v. drip on day 1 and 2 (Regimen 2). C, 60-100mg/m2/day, was administered by i. v. drip and M, 60-100mg/m2/day, was given p. o. daily. P, 20-40mg/m2/day, was also given p. o. daily. As the first step, antileukemic agents were administrated until peripheral blood cell counts and bone marrow nucleated cell counts decreased to less than 1, 200/cmm and 15, 000/cmm, respectively. Treatment with or without N as the second step was started about 3-7 days after the first step treatment.
Eighteen patients were adequately treated by the NCMP two-step regimen and 12 of 18 patients, 66.7%, obtained complete remission (CR). On the basis of the types of leukemia, CR was achieved in 11 of 16 patients with AML, 68.8%, and 1 of 2 patients with AMoL, 50%. The ratio of CR was higher in younger patients (less than 49 y. o.) than in elderly patients (more than 50 y. o.). These ratios were 85.7% and 54.5%, respectively. On the basis of therapeutic regimens, 8 of 11 patients, 72.7%, achieved CR by Regimen 1 and 4 of 7 patients, 57.1%, by Regimen 2. The duration of CR ranged from 1.0 to 39.5+ M (median: 11.5 M). The survivals from the diagnosis of leukemia were from 13 to 41+ M (median: 12.1 M) in all patients and from 4.2 to 41+ M (median: 16.4 M) in responders. As toxic manifestations, digestive side effects such as anorexia, 68.4%, and nausea and vomiting, 21.1%, were marked, but were tolerable.
These results indicate that the NCMP two-step regimen is an effective induction chemotherapy for ANLL.
