摘要
目的探讨儿童白血病协作组(CCLG-ALL)2008(高危组)方案治疗儿童混合表型急性白血病(MPAL)的疗效及安全性。方法回顾性分析16例MPAL患儿的临床资料,所有患者均予采用CCLG-ALL2008(高危组)方案治疗,均进行长期随访,记录早期疗效评估、实际治疗情况及不良反应情况。结果16例患儿均采用CCLG-ALL2008(高危组)方案化疗,诱导缓解治疗33d后CR率为87.50%(14/16),诱导缓解治疗后2例放弃治疗,6例继续化疗,8例接受allo-HSCT治疗;16例患儿中2例放弃治疗,1例死亡,1例失访,死亡患儿为诱导化疗期间重症感染死亡;16例患儿中排除2例放弃治疗,剩余14例患儿5年EFS率为(60.14±5.41)%;其中6例继续化疗患儿5年EFS率为(32.41±4.12)%,8例接受异基因造血干细胞移植(allo-HSCT)患儿5年EFS率为(87.87±5.43)%,差异有统计学意义(P<0.05);16例患儿治疗期间10例出现3~4级严重不良反应,1例发生5级不良反应,严重不良反应发生率为68.75%(11/16),治疗相关死亡率为6.25%(1/16)。结论CCLG-ALL2008(高危组)方案治疗儿童MPAL可取得较高诱导缓解率,且诱导缓解治疗后行allo-HSCT治疗5年EFS率更高,但CCLG-ALL2008(高危组)方案治疗可诱发多种严重不良反应。
Objective To explore the efficacy and safety of the Childhood Leukemia Collaborative Group(CCLG-ALL)2008(high-risk group)regimen in the treatment of pediatric mixed phenotype acute leukemia(MPAL).Methods The clinical data of 16 children with MPAL were retrospectively analyzed,and all patients were treated with CCLG-ALL2008(high-risk group)for long-term follow-up to record early efficacy assessment,actual treatment and adverse reactions.Results All 16 children received chemotherapy with CCLG-ALL2008(high-risk group),The CR rate after 33d of induction-remission treatment was 87.50%(14/16),2 patients abandoned treatment after induction of remission therapy,6 cases of chemotherapy was continued,8 patients received allo-HSCT treatment;2 of the 16 children abandoned treatment,1 death occurred,1 case was lost to visit,The dead children died of severe infection during induction chemotherapy;2 of the 16 children were excluded from abandoning treatment,The 5-year EFS rate of the remaining 14 children(60.14±5.41)%;The 5-year EFS rate in six children with continued chemotherapy(32.41±4.12)%,The 5-year EFS rate of 8 children(a.l l o-HSCT)(87.87±5.43)%,The difference was statistical significant(P<0.05);Ten of 16 children had severe adverse effects of grade 3-4,1 case had grade 5 adverse reactions,The incidence of serious adverse reactions was 68.75%(11/16),Treatment-related mortality was 6.25%(1/16).Conclusion CCLG-ALL2008(high-risk group)treated MPAL,and higher EFS at 5 years after induction remission therapy,but CCLG-ALL2008(high-risk group)can induce several serious adverse reactions.
作者
袁小静
徐春杰
王晓玲
YUAN Xiaojing;XU Chunjie;WANG Xiaoling(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)
出处
《实用癌症杂志》
2023年第6期1038-1040,共3页
The Practical Journal of Cancer
