本文關(guān)鍵詞： 急性淋巴細(xì)胞白血病 兒童 高危組 臨床特點(diǎn) 預(yù)后因素　出處：《中國實(shí)驗(yàn)血液學(xué)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(xì)胞白血病(ALL)高危組患兒的臨床特點(diǎn)和預(yù)后因素。方法:2008年8月至2013年3月在蘇州大學(xué)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(xiǎn)分層并治療,其中標(biāo)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(diǎn)、預(yù)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(shí)間64(3.0-76.3)個(gè)月;誘導(dǎo)化療1個(gè)療程后達(dá)完全緩解55例(緩解率67.1%),復(fù)發(fā)25例(30.5%)[以早中期復(fù)發(fā)為主,與標(biāo)危組差異有統(tǒng)計(jì)學(xué)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(xiàng)因素對(duì)EFS和OS影響均有統(tǒng)計(jì)學(xué)意義(P0.05);多因素COX回歸分析顯示,Ph~+或BCR/ABL~+具有獨(dú)立預(yù)后意義,第33天MRD因素差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:ALL高危組患兒具有誘導(dǎo)緩解率低、復(fù)發(fā)率高和5年pEFS率低的臨床特點(diǎn);存在有Ph~+或BCR/ABL~+是其預(yù)后差的獨(dú)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(xué)附屬兒童醫(yī)院血液科;上海交通大學(xué)附屬第六人民醫(yī)院南院血液科;
【基金】：國家衛(wèi)生和計(jì)劃生育委員會(huì)科研基金項(xiàng)目(W01301)
【分類號(hào)】：R733.71
【正文快照】： 急性淋巴細(xì)胞白血病(ALL)是兒童時(shí)期最常見的惡性疾病,隨著對(duì)兒童ALL臨床分型標(biāo)準(zhǔn)的不斷完善、分型治療方案及具體化療方案細(xì)節(jié)的不斷改進(jìn),其5年無事件生存(EFS)率已達(dá)80%,標(biāo)危型 ALL患兒治愈率更達(dá)到90%以上[1]。然而,有一項(xiàng)或多項(xiàng)危險(xiǎn)因素的高危型ALL患兒仍存在較高的復(fù)發(fā)，

本文編號(hào)：1471091