摘要
目的探索应用类似儿童方案治疗Ph染色体阴性青少年及年轻成人急性淋巴细胞白血病(ALL)患者的疗效和安全性。方法回顾性分析2012年1月至2018年11月在北京协和医院确诊并且应用统一的类似儿童ALL方案治疗的71例15~39岁Ph染色体阴性ALL/淋巴母细胞淋巴瘤(LBL)初治患者的临床资料和生存数据。结果71例患者中,男性46例(64.8%);中位年龄为20(15~38)岁。B-ALL/LBL占69.0%(49/71)。高危ALL占ALL总数的35.5%。诱导治疗的完全缓解率为93.0%。中位随访时间为44个月。2年累积复发率为34.6%(95%CI 27.0%~42.2%)。5年无病生存(DFS)率和总生存(OS)率分别为56.3%和64.3%。完成4个疗程化疗后一线行异基因造血干细胞移植组与化疗组患者的5年OS率差异无统计学意义(P>0.05)。非高危ALL患者的预计5年DFS率和OS率分别为63.1%和73.7%,明显高于高危ALL患者的32.0%和44.4%(P值均<0.001)。不良事件主要为血流感染、真菌感染、股骨头坏死,发生率与既往报道相当。结论类似儿童ALL方案是一种对Ph染色体阴性青少年及年轻成人ALL/LBL患者较为安全和有效的治疗方案。
Objective To investigate the efficacy of using a pediatric-inspired regimen for adolescents and young adults(AYA)with Philadelphia chromosome-negative(Ph-)acute lymphoblastic leukemia/lymphoblastic lymphoma(ALL/LBL)at a single center in China.Methods Clinical data of 71 consecutive newly diagnosed AYA patients with Ph-ALL/LBL on a pediatric-inspired regimen in Peking Union Medical College Hospital from January 2012 to November 2018 were retrospectively analyzed.Results Median age at diagnosis was 20 years(range:15-38),and 46 patients(64.8%)were male.Forty-nine(69.0%)had B-ALL/LBL.Among 62 ALL patients,22(35.5%)were high-risk.Complete remission rate was 93.0%.At follow-up with a median time of 44 months,the estimated 5-year disease-free survival(DFS)and overall survival(OS)was 56.3%and 64.3%,respectively.There was no significant difference in 5-year OS between allogeneic hematopoietic stem cell transplantation group and the continuous chemotherapy group after completion of 4 courses of chemotherapy.The 5-year DFS and OS for the non-high-risk group was 63.1%and 73.7%,respectively,which were significantly higher than 32.0%and 44.4%for the high-risk group,respectively(P<0.001).Conclusions The use of pediatric-inspired regimen for AYAs with Ph-ALL/LBL was feasible and effective.
作者
冯俊
张路
曹欣欣
张炎
杨辰
蔡华聪
陈苗
王为
张薇
朱铁楠
段明辉
李剑
周道斌
Feng Jun;Zhang Lu;Cao Xinxin;Zhang Yan;Yang Chen;Cai Huacong;Chen Miao;Wang Wei;Zhang Wei;Zhu Tienan;Duan Minghui;Li Jian;Zhou Daobin(Department of Hematology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2020年第5期399-404,共6页
Chinese Journal of Hematology
关键词
白血病
淋巴细胞
急性
青少年
年轻成人
费城染色体阴性
Leukemia
lymphoblastic
acute
Adolescents
Young adults
Philadelphia chromosome-negative
