CAG方案治疗复发或初次诱导缓解治疗失败的T细胞急性淋巴细胞白血病

 目的 初步探索CAG方案对复发或初次诱导缓解治疗失败的T细胞急性淋巴细胞白血病（T-ALL）的疗效。方法 6例复发或初次诱导缓解治疗失败的T-ALL患者接受CAG方案再次诱导缓解治疗，并分析该组患者的细胞形态学、免疫学、分子细胞遗传学及临床特征和治疗效果。结果 6例患者经CAG方案再次诱导缓解治疗后均取得了完全缓解（CR），CR率100 %；其具备T-ALL患者常见的临床特征如高外周血白细胞、髓外浸润常见等；细胞形态学均为ALL-L1和L2型；免疫分型均为不成熟T细胞表型；染色体多为正常核型；多数未检测到常见的融合基因。结论 CAG方案对复发或初次诱导缓解治疗失败的T-ALL有效，但仍需扩大病例数进一步验证并探索其作用机制

A pilot study of CAG regimen for relapsed T cell acute lymphocytic leukemia patients and those with failed initial remission-induction results

Objective To study the therapeutic effect of CAG regimen on relapsed T cell acute lympho－cytic leukemia (T-ALL) patients and those with failed initial remission-induction results. Methods 6 T-ALL patients either relapsed or with failed initial remission-induction results received CAG regimen to induce com－plete remission (CR) again. The features of blast morphology, immunophenotype, cytogenetics, abnormal fusion genes and clinical manifestations, treatment outcomes of patients were analyzed. Results All patients achieved CR through CAG regimen, and they were characterized with high leukocyte counts, extramedullary infiltration, which are common in T-ALL. Morphology showed ALL type L1 and L2; immunologic classification revealed im－mature T cell immunophenotype only. Normal karyotype was common, and fusion genes were seldom detected. Conclusion CAG regimen is effective on T-ALL patients either relapsed or with failed initial remission induc－tion results. However, its exact therapeutic effect and mechanism are needed to confirm and explore.