成人急性白血病長期生存例の臨床的解析

抄録

Six adult long-term (more than 6 years) survivors with acute leukemia treated at the Keio University Hospital since 1970 were analyzed in detail in comparison with patients of acute leukemia who died within 5 years.
Four of the six patients had M 2 of the FAB classification (differentiated myeloblastic type), 3 of whom were over 49 year-old. The remaining two were young, and had L 1. Prior to the initiation of therapy, serum lactate dehydrogenase (LDH) levels were significantly (p=0.05) lower in the long-term survivors than other patients. Induction chemotherapies in the six patients were variable, but complete remission were easily achieved in each case. One patient of L1 receiving insufficient maintenance therapies repeated relapses of leukemia and ultimately died. Another patient of L1 developed a CNS relapse 98 months after diagnosis, but reattained complete remission. In two of these six patients aggravation of old tuberculosis was seen in the course of treatment to leukemia. It might suggest that enhanced immunological mechanisms of hosts by tuberculosis took part in long-term survival of acute leukemia.