抄録
In a case of acute myeloblastic leukemia (AML) resistant to quadruple combination chemotherapy (Neo-DCMP), sequential 5-drug regimen including daunomycin (DM), cytosine arabinoside (CA), cytoxan (EX), vincristine sulfate (VCR) and prednisolone (Pred.) was tried. Soon after this therapy, complete remission was achieved, which would be understood by the study of cell cycle effect of leukemic cells by chemotherapies. According to this experience, combination chemotherapy with CA 80mg/m2/day×4, DM 25mg/m2/day×4, EX 120mg/m2/day×4, Pred. 60mg/m2/day×4 and VCR 1.2mg/m2/week×1 or×2 was established and codenamed PADOC.
Thirty courses of PADOC were administered in 20 therapy-resistant cases of acute non-lymphocytic leukemia: all adult patients from 19 to 74 (median 40) year-old; AML, 11 cases, acute monocytic leukemia (AMoL), 8 cases and paramyeloblastic (AMpL), 1 case.
Of 20 patients 12 (60.0%) obtained complete remission (CR) and 8 (40.0%) failure. There was not so much difference in chemotherapy effect between patients older than 40 years and younger than that; the CR rate being 5/10 (50.0%) and 7/10 (70.0%), the median survival 8 months and 10 months respectively. The CR rate in each type of acute leukemia was 6/11 (54.5%) in AML, 6/8 (75.0%) in AMoL and 0/1 in AMpL. CR was obtained after 1 or 2 courses of PADOC. The median duration to reach CR was 36 days from the beginning of the treatment (19∼68 days). The median survival of 20 patients was 10 (2∼42. 1/3+) months.
The prolongation of survival was obtained by PADOC in therapy-resistant cases with acute non-lymphocytic leukemia.
