摘要
目的评价儿童急性髓系白血病(AML)的疗效并探讨其预后相关因素。方法对2015年11月—2019年12月诊断的符合入组标准的55例初诊AML患儿统一采用CCLG-2015方案治疗,回顾性分析其临床特征、预后及影响因素。采用Kaplan-Meier方法、COX回归模型进行统计学处理。结果(1)55例患儿中位随访时间22(2~58)个月,第1个疗程CR率76.4%(42/55),第2个疗程CR率88.7%(47/53)。3年无事件生存率(EFS)为(52.6±7.0)%,3年总生存率(0S)为(61.4±7.3)%。(2)单因素分析诱导Ⅰ后MRD、初诊时骨髓白血病细胞比例、第1个疗程是否CR、性别为影响EFS的因素;诱导Ⅰ后MRD、初诊时骨髓白血病细胞比例、第1疗程是否CR、诱导Ⅱ后MRD为影响OS的因素。(3)多因素分析诱导Ⅰ后MRD≥5%是影响EFS、OS的独立因素。结论诱导Ⅰ后MRD≥5%是影响AML患儿预后的独立危险因素。
Objective To investigate the clinical outcomes and prognostic predictors in children with acute myeloid leukemia(AML).Methods In this retrospective analysis,55 consecutive new-diagnosed subjects between November,2015 and December,2019 were enrolled.All patients subsequently received chemotherapy following CCLG-2015 regimen.Clinical characteristics,long-term prognosis and prognostic factors were analyzed.Statistical methods included Kaplan-Meier method and COX regression analysis.Results(1)Median follow-up was 22(2-58)months.42 patients(76.4%)achieved complete remission(CR)after 1 cycle and 47 patients(88.7%)achieved CR after 2 cycles.The 3-year EFS rate and OS rate were 52.6%±7.0%and 61.4%±7.3%.(2)Univariate analyses showed that minimal residual disease(MRD)after 1 cycle,bone marrow blast cell percentage at diagnosis,CR after 1 cycle,and gender were significant predictors for EFS.MRD after 1 cycle,bone marrow blast cell percentage at diagnosis,CR after 1 cycle and MRD after 2 cycles were significant predictors for OS.(3)A multivariate Cox regression model showed that MRD≥5%after 1 cycle was significantly associated with OS and EFS.Conclusions MRD≥5%after 1 cycle was independently prognostic factor in AML children.
作者
刘丙菊
管国涛
戴云鹏
LIU Bingju;GUAN Guotao;DAI Yunpeng(Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)
出处
《中国小儿血液与肿瘤杂志》
CAS
2021年第6期332-336,358,共6页
Journal of China Pediatric Blood and Cancer
关键词
急性髓系白血病
化疗
儿童
预后
Acute myeloid leukemia
Chemotherapy
Child
Prognosis
