| Objective:To evaluate the effectiveness and safety of Hyper-CVAD regimen and CALLG2008 regimen in the treatment of newly diagnosed acute lymphoblastic leukemia(ALL).Methods:This study was conducted as a retrospective review of medical records of ALL patients at Fujian medical university union hospital,from January 2010 to February 2017.Six hundred and eight ALL patients underwent chemotherapy..Hyper-CVAD protocol group included 122 patients(49 patients with cytarabine dose of 1-2g/m~2,73 patients with 3g/m~2):76 patients were male,46 patients werefemale;44 patients were standard-risk,78 patients were high-risk;The age at diagnosis was 36(15-70)years.CALLG2008 protocol group included 486 patients:299 patients were male,187 patients were female;227 patients were standard-risk,259 patients were high-risk.The age at diagnosis was 31(14-68)years.The complete remission,early mortality,1-year,3-year,and 5-year disease-free survival(DFS),and overall survival(OS)rates were measured as primary endpoints.Results:The complete remission rates of Hyper-CVAD group and CALLG2008group were 88.5%and 86.4%(p=0.539),respectively.The 1-year,3-year,5-year DFS of Hyper-CVAD group and CALLG2008 group were 52.4%,51.0%(p=0.778),20.7%,26.1%(p=0.198),7.4%,12.3%(p=0.122),respectively.The 1-year,3-year,5-year OS of Hyper-CVAD group and CALLG2008 group were 73.8%,65.4%(p=0.080),36.9%,39.9%(p=0.540),22.1%and 25.5%(p=0.439)respectively.There was no statistical difference in DFS/OS between those two groups.The early mortality rates of Hyper-CVAD group and CALLG2008 group were 2.5%(3/122)and7.6%(37/486)(p=0.040),respectively.In the subgroup analyses of the Hyper-CVAD protocol,the CR rates of cytarabine dose 1-2g/m~2 and 3g/m~2 were 89.8%,87.7%(p=0.718)respectively;the early mortality rates were 0%(0/49),4%(3/73)(p=0.151)respectively;the 1-year,3-year,5-year OS were 69.4%,76.7%(p=0.367),36.7%,38.3%(p=0.856),22.4%and 20.5%(p=0.802),respectively.The chemotherapy-related side effects in Hyper-CVAD group and CALLG2008 group were mainly oral infection(55.7%,53.9%),respiratory infection(77.0%,81.1%),diarrhea(23.8%,23.0%),perianal infection(18.0%,17.1%),septicemia(15.6%,15.0%),fungal infection(45.9%,46.9%),pancreatitis(0.8%,3.9%),vomiting(90.2%,89.9%),transaminase elevation(44.3%,54.9%),alopecia(35.2%,38.1%),coagulation disorders(31.1%,42.6%).The rates of transaminase increase and coagulation disorders in CALLG2008 group were significantly higher than those in Hyper-CVAD group.Conclusion:1.there was no significant difference between Hyper-CVAD regimen and CALLG2008 regimen in CR and DFS,OS in 1 year,3 years and 5 years.the early mortality of Hyper-CVAD regimen was lower than that of CALLG2008 regimen.2.Hyper-CVAD as an induction regimen for ALL was feasible.The Chemotherapy related side effects are controllable.Hyper-CVAD yielded a high rate of CR.OS were comparable to CALLG2008 but still unsatisfactory..3.In subgroup analyses of cytarabine dosage of 3 g/m~2 and cytarabine dosage of 1-2g/m~2 in Hyper-CVAD protocol,there were no significant difference in CR,1-year,3-years,5-years DFS/OSor early mortality rate. |
