Assuntos
Anestesia Geral , Eletroconvulsoterapia , Guias de Prática Clínica como Assunto , Amnésia/etiologia , Relação Dose-Resposta a Droga , Eletroconvulsoterapia/efeitos adversos , Eletroconvulsoterapia/métodos , Humanos , Planejamento de Assistência ao Paciente , Valores de Referência , Fatores de RiscoRESUMO
For the last 13 years, 47 patients with ALL over 15 years old (range 15-72; median 21) entered a 'total-therapy' programme. All cases received a 6-8 week induction course of PRD, VCR, DRB and/or L-ASN. Prophylaxis of CNS was done by cranial radiotherapy plus i.t. MTX in 32/45 patients who attained complete remission (CR). After CR, subsequent therapy involved a programme of maintenance with 6MP and MTX at full doses. Pulses of intermittent reinforcement (PRD, VCR and DRB) were done for 2 weeks, every 3 months, for at least 3 years. CR was achieved in 42/47 patients (89.3%). The median relapse-free survival of the patients who attained CR was 57 months, with an 8-year estimated disease-free survival rate of 43% for those cases. If actuarial assumptions were to be sustained, it would indicate an encouraging cure rate of 38% of all our adult ALL patients (mainly in those cases between 15 and 30 years old).
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Leucemia Linfoide/tratamento farmacológico , Adolescente , Adulto , Idoso , Asparaginase/administração & dosagem , Daunorrubicina/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Vincristina/administração & dosagemRESUMO
Kinetic studies of marrow dividing granulocytic precursors (mitotic index and flash labeling index with 3H-TDR) were carried out in 11 patients with oligoblastic leukemia (OBL). The results were compared with similar data from cases of conventional acute non-lymphocytic leukemia (ANLL). The cytokinetic results were as follows: MI (%) in OBL, mean = 0.75; MI (%) in ANLL, mean = 0.66; p greater than 0.7; LI (%) in OBL, mean = 15.0; LI (%) in ANLL, mean = 15.4, p greater than 0.7. The lack of cytokinetic differences between these two groups of patients stands in favor of the hypothesis that OBL might represent a special type of smoldering leukemia with a 'plateau' of blast cell accumulation established at a subleukemic level.