Erişkin akut lenfoblastik lösemili olgularda yoğun indüksiyon kemoterapisi sonuçları

Son 15 yılda yapılan çalışmalarda erişkin akut lenfoblastik lösemili hastaların büyük çoğunluğunda yoğun indüksiyon kemoterapisi ile remisyon sağlanabildiği gösterilmiştir. Bu çalışmada Hoelzer ve arkadaşlarının önerdikleri protokole uygun olarak yoğun indüksiyon kemoterapisi uygulanan 19 erişkin akut lenfoblastik lösemili hastanın sonuçları retrospektif olarak değerlendirilmiş ve aynı dönemde daha az yoğunlukta indüksiyon kemoterapisi uygulanan 23 hastanın sonuçları ile karşılaştırılmıştır. Yoğun indüksiyon uygulanan 19 hastada remisyon oranı % 84.2 olup ortalama 61 aylık izlem sonunda remisyon süresi ortalama 48 ay ve tüm hastalarda ortalama sağkalım süresi ise 24 ay bulunmuştur. Kontrol grubunda ise bu değerler sırası ile % 60.8, 6 ay ve 9 ay bulunmuştur. Yoğun indüksiyon sırasında erken mortalite görülmemiş olup tüm hastalarda febril nötropenik atak izlenmiştir. Bu sonuçlara göre yoğun indüksiyon kemoterapisi erişkin akut lenfoblastik lösemili hastalarda remisyon oran ve süresini istatiksel olarak anlamlı artırmakta ancak erken mortalitede artışa neden olmamaktadır.

Anahtar Kelimeler:

Lösemi, lenfositik, akut, İlaç tedavisi, Remisyon indüksiyonu, Geriyedönük çalışma, Sağkalım

The results of intensive induction chemotherapy in adult patients with acute lymphoblastic leukemia

In the last 15 years several studies have showed that most of the patients with acute lymphoblastic leukemia can achieve complete remission by intensive induction chemotherapy. In this study, we retrospectively investigated the results of the treatment of 19 adult patients with acute lymphoblastic leukemia treated by intensive induction chemotherapy. The results were compared with the 23 patients who were given less intensive induction chemotherapy during the same period. In the intensive chemotherapy group the remission rate was 84.2 %. After 61 months of follow-up, the median remission duration was 48 months and overall survival was 24 months. In control group, remission rate was 60.8 %, remission duration 6 months and total survival was 9 months. There was no early mortality detected due to intensive induction chemotherapy although all the patients had febrile neutropenic attacks during the treatment period. In conclusion intensive induction chemotherapy car significantly increase the rate and duration of remission even though it does not have any effect on early mortality rates.

Keywords:

Leukemia, Lymphocytic, Acute, Drug Therapy, Remission Induction, Retrospective Studies, Survival,

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