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