摘要
目的评价两种诱导缓解治疗方案(3+7方案和3+10方案)治疗儿童急性髓系白血病(AML)的疗效。方法回顾分析2010年1月至2015年1月接受化疗的AML患儿100例,按入院时间分别接受3+7方案(AML-06方案,A组)和3+10方案(改良AML方案,B组),比较两组的疗效及不良反应。结果 A组56例,男31例、女25例,中位年龄8.2岁(全距1.0~13.0岁),FAB分型,M1型5例、M2型25例、M4型11例、M5型10例、M6型2例、M7型3例;B组44例,男26例、女18例,中位年龄9.3岁(全距1.4~12.5),FAB分型:M2型17例、M4型14例、M5型9例、M6型2例、M7型2例。A组首疗诱导完全缓解(CR)率为48.2%低于B组首疗完全缓解率(70.4%),两组间差异有统计学意义(P<0.05)。B组的骨髓抑制期较A组长,诱导化疗后中性粒细胞数、血红蛋白、血小板恢复时间也均较A组长,差异均有统计学意义(P均<0.05)。A组化疗相关死亡率1.8%,B组为2.3%,差异无统计学意义(P>0.05)。A组3年总生存率为75.0%,B组总生存率为86.4%,差异有统计学意义(P<0.05)。结论两种治疗方案对AML均有效,3+10方案完全缓解率高,不良反应无明显增加。
Abstract：Objective To compare the efficacy and safety of induction therapy in 3＋7 protocol and 3＋10 protocol in children with acute myeloid leukemia （AML）. Methods Two protocols were carried out in our hospital during January 2010 to January 2015, namely 3＋7 protocol（AML-06,A group） and 3＋10 protocol （modified AML protocol, B group）. A total of 56 cases aged from 1 year-old to 13 year-old were enrolled in A group with male to female ratio at 31：25. Five of them were classified as FAB M1, 25 as M2, 11 as M4, 10 as M5, 2 as M6 and 3 as M7. Another 44 cases aged from 1 year to 12 years were enrolled in B group with a male to female ratio at 26：18, and 17 cases were classified as FAB M2, 14 as M4, 9 as M5, 2 as M6, and 2 as M7. Efficacy and adverse events were compared between the two groups. Results The complete remission rate （CR） of B group was 70.4%, while CR in A group was 48.2%. Considering the CR, 3＋10 protocol showed higher efficacy than 3＋7 protocol （P〈 0.05）. The major adverse event was bone marrow suppression. Treatment-related mortality （TRD） in A group was 1.8%, which was lower than that in B group （2.3%）. The overall survival rate in A group was 75.0%, which was lower than that in B group （86.4%, P〈 0.05）. Conclusions The induction therapy of 3＋10 protocol and 3＋7 protocol showed effectiveness for AML treatment. The 3＋10 protocol showed a higher CR than 3＋7 protocol with no TRD increase, indicating that the 3＋10 protocol should be recommended for AML treatment in children.
作者
翟钦
王易
何海龙
卢俊
肖佩芳
丁飞
吕慧
孙伊娜
范俊杰
胡绍燕
ZHAI Qin;WANG Yi;HE Hailong;LU Jun;XIAO Peifang;DING Fei;LYU Hui;SUN Yina;FAN Junjie;HU Shaoyan(Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215000, Jiangsu, China;Hematology and Oncology Department,Suzhou Children’s Hospital Affiliated to Soochow University, Suzhou 215000, Jiangsu, China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2018年第5期321-325,共5页
Journal of Clinical Pediatrics
基金
国家自然科学基金项目(No.81170513
81370627)
江苏省科技厅临床医学科技专项江苏省临床医学研究中心项目(No.BL 2012005)
江苏省卫生厅面上项目(No.H 201212)
苏州市儿童白血病重点实验室(No.LCZX 201507)
苏州市临床重点专病(No.SZS201615)
关键词
急性髓系白血病
诱导化疗
疗效
不良反应
儿童
acute myeloid leukemia
induction chemotherapy
curative effect
adverse effect
child
