- 期刊
Recent Advances in Chemotherapy for Hematological Malignancies in Japan
並列摘要
Dramatic progress in chemotherapy for hematological malignancies has been made because of the development of new molecular-targeted agents. In patients with acute promyelocytic leukemia (APL), remission induction chemotherapy of all-trans retinoic acid (ATRA) combined with anthacyclines and anthacycline-based consolidaton chemotherapy induced 90% complete remission and 65% event-free survival at 6 years. Arsenic trioxide and Am-80 are effective for APL relapse after treatment with ATRA. On the other hand, the results of acute myelogenous leukemia (AML) treatment have not substantially improved for the past two decades, with complete remission rates of 70-80% and long-term survival rates of 30-40%. High-dose ara-C may improve the long-term outcome of AML patients with t(8;21) or inv(16), and gemtuzumab ozogamicin-combined chemotherapy or the priming effect of G-CSF on leukemic cells may improve that of intermediate-risk AML patients. Using imatinib mesylate, hematological remission is achieved in almost all patients, and cytogenetic response is achieved in about 80% of patients in the chronic phase of chronic myelogenous leukemia. The Japan Adult Leukemia Study Group study revealed that the combination of imatinib mesylate with conventional chemotherapy achieved a complete remission rate of more than 90% in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. R-CHOP (rituximab, cyclophosphamide, adriamycin, vincristine and prednisolone) has been established as the standard chemotherapy for diffuse large B-cell lymphoma. The combination of rituximab with a purine analogue, fludarabine or cladribine, may improve the outcome of indolent B-cell non-Hodgkin's lymphoma. Bortezomib-combined chemotherapies are candidates for first-line chemotherapy for multiple myeloma.