本文關鍵詞： 急性淋巴細胞白血病 兒童 高危組 臨床特點 預后因素　出處：《中國實驗血液學雜志》2017年02期 　論文類型：期刊論文

【摘要】：目的:探討急性淋巴細胞白血病(ALL)高危組患兒的臨床特點和預后因素。方法:2008年8月至2013年3月在蘇州大學附屬兒童醫(yī)院就診的初診ALL患兒共421例,均采用中國兒童白血病協(xié)作組(CCLG)-2008-ALL方案危險分層并治療,其中標危組148例,中危組191例,回顧性分析高危組82例患兒的臨床特點、預期5年概率無事件生存(pEFS)率及總生存(pOS)率。結(jié)果:82例病人中位隨訪時間64(3.0-76.3)個月;誘導化療1個療程后達完全緩解55例(緩解率67.1%),復發(fā)25例(30.5%)[以早中期復發(fā)為主,與標危組差異有統(tǒng)計學意義(P=0.013)],死亡27例(32.9%);5年pEFS率及pOS率分別為57.20%和58.50%。單因素分析顯示,Ph~+或BCR/ABL~+和第33天MRD10~(-2)兩項因素對EFS和OS影響均有統(tǒng)計學意義(P0.05);多因素COX回歸分析顯示,Ph~+或BCR/ABL~+具有獨立預后意義,第33天MRD因素差異無統(tǒng)計學意義。結(jié)論:ALL高危組患兒具有誘導緩解率低、復發(fā)率高和5年pEFS率低的臨床特點;存在有Ph~+或BCR/ABL~+是其預后差的獨立因素。
[Abstract]:Objective: to study ALL in acute lymphoblastic leukemia (ALL). Methods: from August 2008 to March 2013, 421 patients with ALL were admitted to the affiliated Children's Hospital of Suzhou University. All of them were treated with CCLGG-2008-ALL risk stratification and treatment. 148 cases in the bid group and 191 cases in the middle risk group. The clinical features of 82 children in high-risk group were analyzed retrospectively. Results the median follow-up time of 82 patients was 643.0-76.3 months. 55 cases of complete remission after one course of induced chemotherapy (remission rate 67.1%, recurrence 25 cases 30.5%). [The recurrence was mainly early and middle stage, and the difference between the two groups was statistically significant (P < 0.013), and 27 cases died (32. 9%). The pEFS rate and pOS rate in 5 years were 57.20% and 58.50, respectively. Two factors, Phor BCR / ABL ~ and 33rd day MRD10 / 2, had significant effects on EFS and OS (P 0.05). Multivariate COX regression analysis showed that COX or BCR / ABL ~ had independent prognostic significance. There was no significant difference in the factors of MRD on the 33rd day. Conclusion the children in the high risk group of 1: all have the characteristics of low induced remission rate, high recurrence rate and low pEFS rate in 5 years. The existence of Ph- or BCR / ABL ~ is an independent factor for poor prognosis.
【作者單位】： 蘇州大學附屬兒童醫(yī)院血液科;上海交通大學附屬第六人民醫(yī)院南院血液科;
【基金】：國家衛(wèi)生和計劃生育委員會科研基金項目(W01301)
【分類號】：R733.71
【正文快照】： 急性淋巴細胞白血病(ALL)是兒童時期最常見的惡性疾病,隨著對兒童ALL臨床分型標準的不斷完善、分型治療方案及具體化療方案細節(jié)的不斷改進,其5年無事件生存(EFS)率已達80%,標危型 ALL患兒治愈率更達到90%以上[1]。然而,有一項或多項危險因素的高危型ALL患兒仍存在較高的復發(fā)，

本文編號：1471091