| Autor: |
E N, Parovichnikova, Iu R, Davidian, V G, Isaev, A N, Sokolov, G A, Kliasova, L P, Mendeleeva, L S, Liubimova, E N, Ustinova, E O, Gribanova, E S, Mavrina, S M, Kulikov, K D, Kaplanov, T P, Zagoskina, E I, Sviridova, L V, Gavrilova, V G, Savchenko |
| Rok vydání: |
2009 |
| Předmět: |
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| Zdroj: |
Terapevticheskii arkhiv. 81(7) |
| ISSN: |
0040-3660 |
| Popis: |
To analyse the results of the treatment according to ALL-2005 protocol for adult patients with acute lymphoblastic leukemia (ALL); on the basis of the summarized evidence on ALL treatment to propose principles for development of a new program of ALL treatment in 15-55-year-old patients.Five hematological centers (in Moscow, Saransk, Volgograd, Tambov, Kirov) participated in ALL-2005 protocol trial initiated in 2005. A total of 71 adult patients with ALL (age median 27 years) were treated. The results of the MB-2002 study with participation of 16 patients aged 16-23 years performed in the State Hematological Research Center (SHRC) were reviewedThe results of the induction therapy according to ALL-2005 protocol conducted in Moscow SHRC were good: a complete remission was achieved in 90% patients, early lethality was 6%, resistance was observed in 4%. In regional centers lethality in remission was higher, 5-year overall survival was 28% (in SHRC it was 56%), recurrence-free survival in regional center was 22% versus 51%, respectively. Long-term response by ALL-2005 and MB-2002 in patients aged 19-23 was the same, but toxicity of ALL-2005 treatment was higher (no lethality and 5, 4% in induction and remission, respectively).The decision was made on design of a new protocol of treatment of Ph-negative ALL for patients aged from 15 to 55 years the main principles of which are the following: continuous treatment with modification of cytostatic drugs doses depending on myelosuppression severity; assessment of tumor cells sensitivity to prednisolone and its replacement for dexametasone throughout the treatment; prolongation of L-asparaginase treatment with elevation of its total dose; monitoring of minimal residual disease (MRD) for decision on late intensification in patients with MRD at late treatment stages (5 months). |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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