Эффективность первого и повторного курсов индукционной терапии больных de novo острым миелоидным лейкозом

Одним из важнейших факторов выживаемости больных острым миелоидным лейкозом является достижение полной ремиссии. Для оценки эффективности первого индукционного курса «7 + 3» были проанализированы результаты лечения 93 больных de novo острым миелоидным лейкозом в возрасте от 17 до 76 лет. Полная ремиссия была достигнута у 59,1 % больных, ответа не было у 33,1 % больных и ранняя смерть констатирована у 7,5 % больных. Вариант ответа зависел от возраста и характера цитогенетических аберраций. Наименьшая эффективность химиотерапии отмечена у больных с моносомным кариотипом. В качестве повторного индукционного курса была использована химиотерапия по схеме «7 + 3» или с введением цитоарабина в разовой дозе ≥ 1 г/м² в монорежиме или в комбинации с антрациклиновыми антибиотиками. Полная ремиссия была констатирована у 11,5 % больных, у которых выявлен промежуточный прогностический вариант кариотипа. При выборе интенсивности и состава повторного индукционного курса химиотерапии необходимо ориентироваться на молекулярно-генетический фенотип лейкозных клеток.

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