摘要
目的评价234例儿童急性淋巴细胞白血病(ALL)单中心10年临床疗效及主要预后相关因素。方法以2006年1月—2015年4月于我院血液科符合入组标准的234例ALL患儿纳入研究,接受CCCG-ALL 2005方案治疗随访,分析疗效及预后因素。结果234例患儿诱导缓解率为96.6%。5年累积复发率为(17.5±2.6)%,10年累积复发率为(22.3±3)%,中位复发时间为26.5(2~95)个月。5年EFS为(74.8±2.8)%,10年EFS(68.7±3.3)%,5年OS(82.6±2.5)%,10年OS(79.6±3.0)%。234例患儿根据不同危险度分为低危组(n=86)、中危组(n=69)、高危组(n=79)。三组的5年EFS率分别为(84.6±4.0)%、(67.5±5.7)%、(61.0±5.7)%,10年EFS率分别为(79.8±5.0)%、(65.5±6.0)%、(55.4±7.4)%。低危组患儿的长期生存情况明显优于中高危组患儿(P=0.003)。多因素分析,早期治疗反应、治疗后低MRD水平是影响EFS的预后因素,诱导治疗后第55天MRD持续阳性预后不良。结论泼尼松治疗反应、MRD监测对ALL患儿预后评估有意义。诱导治疗第55天MRD水平是影响长期生存的预后因素;其持续阳性患儿预后较差。
Objective To analyze the clinical outcome and the prognostic factor of children with acute lymphoblastic leukemia(ALL).Methods 234 newly diagnosed ALL patients treated with CCCG-ALL 2005 regime from January 2006 to April 2015 were included in this study.The clinical characteristics,the event-free survival(EFS),the overall survival(OS)and the prognostic analysis were evaluated.Results The CR rate of all 234 patients was 96.6%.The 5-year recurrence rate was(17.5±2.6)%and the 10-year recurrence rate was(22.3±3)%.The median follow-up relapse duration was 26.5(2~95)months.The 5-year event-free survival(EFS)and the 10-year EFS was(74.8±2.8)%and(68.7±3.3)%.The 5-year overall survival(OS)and the 10-year OS was(82.6±2.5)%and(79.6±3.0)%,respectively.234 patients were divided into three groups according to different risk level,Low risk(n=86),intermediate risk(n=69)and high risk(n=79).The 5-year EFS of three groups was(84.6±4.0)%,(67.5±5.7)%and(61.0±5.7)%.The 10-year EFS of three groups was(79.8±5.0)%、(65.5±6.0)%、(55.4±7.4)%,respectively.The 5-year EFS and the 10-year EFS in low risk group were much higher than those in intermediate and high risk groups(P=0.003).Multivariate analysis demonstrated early treatment response and low level of minimal residual disease(MRD)were significant favorable factors,while MRD persistent positive on day 55 after induction treatment was a risk factor.Conclusions Efficacy of early treatment responses and MRD monitoring are of great significant in prognosis evalution.The MRD level on day 55 after induction treatment is associated with long term survival.Patients with MRD persistent positive on day 55 after induction have an unfavorable prognosis.
作者
李红
蒋慧
朱嘉莳
张娜
邵静波
杨静薇
陈凯
邹冰
夏敏
LI Hong;JIANG Hui;ZHU Jiashi;ZHANG Na;SHAO Jingbo;YANG Jingwei;CHEN Kai;ZOU Bing;XIA Min(Department of Hematology and Oncology, Children′s Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai 200040, China)
出处
《中国小儿血液与肿瘤杂志》
CAS
2020年第2期60-64,共5页
Journal of China Pediatric Blood and Cancer
关键词
儿童
急性淋巴细胞白血病
无事件生存
总生存
预后
Children
Acute lymphoblastic leukemia
Event-free survival
Overall survival
Prognosis
