期刊文献+

儿童急性淋巴细胞白血病的临床分析 被引量:14

Clinical analysis of children acute lymphoblastic leukemia
原文传递
导出
摘要 目的 分析初诊儿童急性淋巴细胞白血病的临床特征及远期疗效情况,提高急性淋巴细胞白血病患儿的总生存率(overall survival,OS)和无事件生存率(event-free survival,EFS).方法 收集2005年至2010年住院治疗的初诊急性淋巴细胞白血病80例患儿的临床资料,采用急性淋巴细胞白血病IC-BFM2002为基础的化疗方案,运用Kaplan-Meier法统计分析患儿的5年OS和EFS.结果 80例患儿,男女比例1.22∶1,中位年龄4岁3个月,标危33例(41.2%),中危37例(46.3%),高危10例(12.5%),白细胞(WBC≥20×109/L)22例(27.5%),BCR/ABL阳性3例(3.8%);MLL基因重排1例(1.3%);TEL/AML阳性17例(21.3%).完全缓解79例(98.8%),5年OS和EFS分别为(85.9±4.0)%和(79.2±4.7)%,其中标危组5年EFS(86.6±6.4)%,中危组5年EFS (81.1±6.4)%,高危组5年EFS(48.0±16.4)%,组间比较差异有统计学意义(x2=7.03,P<0.05).复发12例(15.o%),中位时间23.5个月.死亡11例(13.8%),中位时间13个月.结论 初诊儿童急性淋巴细胞白血病患儿的疗效好,标准的分型诊断及危险度分层治疗有利于提高患儿的生存质量. Objective To analysis the clinical characteristics and the long-term effect of children with acute lymphoblastic leukemia (ALL).Methods From 2005 to 2010,80 newly diagnosed ALL children were enrolled and treated with protocol based on ALL-BFM2002.The five-years overall survival (OS)and event-free survival(EFS) were analyzed by the method of Kaplan-Meier.Results For the 80 patients,male to female ratio is 1.22∶1.The median age was 4.3 years.33 were in standard risk(41.2%),37 were in medium risk(46.3%),and 10 were in high risk(12.5%).22 had white blood cell count ≥20 x 109/L(27.5%).three patients with BCR-ABL translocation(3.8%),one patient with MLL gene rearrangement(1.3%),17 patients with TEL-AML translocation (21.3%).During induction therapy,79 patients (98.8 %) achieved complete remission(CR).The five-years OS and EFS were (85.9 ± 4.0) % and (79.2 ± 4.7) % respectively.The five-years EFS:SR group (86.6 ± 6.4) %,IR group (81.1 ± 6.4) %,HR group (48.0 ± 16.4) %.The difference among risk groups was statistically significant(x2 =7.03,P <0.05).12 patients relapsed(15.0%),the median time from diagnosis to relapse was 23.5 months.11 patients died (13.8 %).Conclusion According to stratification by risk factors and risk-adapted therapy,the quality of ALL children's life had improved.
出处 《国际儿科学杂志》 2014年第2期185-188,共4页 International Journal of Pediatrics
关键词 急性淋巴细胞白血病 无事件生存率 儿童 Acute, lymphoblastic, Leukemia Children Event-free survival
  • 相关文献

参考文献10

  • 1Pui CH, Robison LL, Look AT. Acute lymphoblastic leukemia [ J ]. Lancet, 2008,371 : 1030-43. 被引量:1
  • 2方建培,罗学群,屠立明,赖冬波,吴学东,孙晓菲,陈健良,李志光,陈纯,林愈灯,柯志勇,赵玉红,何岳林,甄子俊,何政贤,周敦华,官晓清,张玉明,何丽雅,黄绍良.GZ-2002急性淋巴细胞白血病化疗方案治疗非高危儿童急性淋巴细胞白血病多中心协作临床研究[J].中国小儿血液与肿瘤杂志,2011,16(2):60-65. 被引量:27
  • 3张之南,沈悌主编..血液病诊断及疗效标准 第3版[M].北京:科学出版社,2007:271.
  • 4赵卫红,华瑛,卢新天,孙桂香,李齐岳,于载泺.急性淋巴细胞白血病患儿长期疗效分析[J].实用儿科临床杂志,2012,27(3):192-193. 被引量:5
  • 5Gao YJ, Qian XW,Lu FJ,et al. Improved outcome for children with non-high risk acute lymphoblastic leukaemia after using an ALL 112- BFM2002-based protocol in Shanghai, China [ J ]. Br J Haematol, 2013,160(3) :363-7. 被引量:1
  • 6Schrappe A, Reiter A, Zimmerreann M, et al. Long-term results of four consecutive trials in childhood ALL performed by the ALL-BFM study group from 1981 to 1995. Berlin-Frankfurt-Miinster[ J]. Leuke- mia,2000,14(12) :2205-22. 被引量:1
  • 7Mtiller J, Kovfics G, Jakab Z, et al. Treatment results with ALL-BFM- 95 protocol in children with acute lymphoblastic leukemia in Hungary [J]. Orv Hetil,2005,146(2):75-80. 被引量:1
  • 8Glodkowska E, Bialas A, Jackowska T. Comparison of the present and previously used protocol of risk stratification in children with acute lymphoblastic leukemia[ J ]. Med Wieku Rozwo,2007,11 (2) : 153-158. 被引量:1
  • 9刘子勤,王天有.儿童侵袭性真菌感染的应对策略[J].国际儿科学杂志,2009,36(5):551-552. 被引量:2
  • 10黄建美,黄建英,蔡若吟,等.白血病患儿医院感染的控制与护理[J].中国实用护理杂志,2007,23(2):104. 被引量:1

二级参考文献25

  • 1Christopher DP, Jason PF, Nasia S. Diagnosis of lnvasive Aspergillosis Using a Galaetomannan Assay: A Meta Analysis. Clin Infect Dis, 2006,42 (10) : 1417-1427. 被引量:1
  • 2Olivier A,Anne A,Fanny W, et,al.Treatment with Piperacillin-Tazobactam and False Positive Aspergillus Galactomannan Antigen Test Results for Patients with Hematological Malignancies. Clin Infect Dis, 2004,38 (6) : 917-920. 被引量:1
  • 3Iwen PC, Freifeld AG, Bruening TA, et al. Use of a pan-fungal PCR assay for detection of fungal pathogens in a commercial blood culture systemo J Clin Microbiol, 2004,42 (5) : 2292-2293. 被引量:1
  • 4Linder N, Klinger G, Shalit I, et al. Treatment of candidaemia in premature infants: comparison of three amphotericin B preparations. J Antimicrob Chemother, 2003,52 ( 4 ) : 663 -667. 被引量:1
  • 5Schwarze R, Penk A, Pittrow L. Treatment of candidal infections with fl uconazole in neonates and infants. Eur J Med Res, 2000,5 (5) : 203-208. 被引量:1
  • 6Mondal RK, Singhi SC, Chakrabarti AMJ. Randomized comparison between fluconazole and itraconazole for the treatment of candidemia in a pediatric intensive care unit: a preliminary study. Pediatr Crit Care Med, 2004, 5 (6) :561-565. 被引量:1
  • 7Zaoutis TE, Benjamin DK, Steinbaeh WJ. Antifungal treatment in pediatric patients. Drug Resist Updat, 2005,8 (4) : 235-245. 被引量:1
  • 8Segal BH,Barnhart LA,Anderson VL,et al. Posaconazole as salvage therapy in patients with chronic granulomatous disease and invasive filamentous fungal infection. Clin Infect Dis,2005,40( 11 ) : 1684-1688. 被引量:1
  • 9Antachopoulos C,Walsh TJ,Roilides E.Fungal infections in primary immunodefi ciencies. Eur J Pediatr,2007,166( 11 ) : 1099-1117. 被引量:1
  • 10Van Burik JA, Ratanatharathorn V, Stepan De, et al. Micafungin versusfl uconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantation. Clin hffect Dis,2004,39(10) : 1407-1416. 被引量:1

共引文献31

同被引文献135

引证文献14

二级引证文献36

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部