K. Uozumi et al., COMBINATION CHEMOTHERAPY (RCM PROTOCOL - RESPONSE-ORIENTED CYCLIC MULTIDRUG PROTOCOL) FOR THE ACUTE OR LYMPHOMA TYPE ADULT T-CELL LEUKEMIA, Leukemia & lymphoma, 18(3-4), 1995, pp. 317-323
43 patients with the acute or lymphoma type ATL were treated with the
new combination chemotherapy (RCM protocol: response-oriented cyclic m
ultidrug protocol) between January 1989 and December 1991, Complete re
sponse (CR) and partial response (PR) were achieved in 20.9% and 65.1%
of all treated patients respectively. The median duration of survival
was 6.0 months. The survival duration of patients with a high serum l
actate dehydrogenase (LDH) value (greater than or equal to 1,000 unit)
and/or a poor performance status (PS) (PS 3 or 4) were also improved
but not in patients with a severe leukocytosis (greater than or equal
to 35,000/mu l). Toxicity was mild (grade 1 or 2) except hematologic t
oxicity in 4 patients (9.3%) and alopecia in one patient (2.3%). In sp
ite of many patients with a poor PS (PS 3 or 4), our chemotherapeutic
results are equal or superior to other previous reports. It seems that
response-oriented chemotherapy is suitable for the ATL patients with
poor prognostic factors. These results indicate that the RCM protocol
is very useful as the first choice chemotherapy for the acute or lymph
oma type ATL.