Stiller C A, Benjamin S, Cartwright R A, Clough J V, Gorst D W, Kroll M E, Ross J R, Wheatley K, Whittaker J A, Taylor P R, Proctor S J
Childhood Cancer Research Group, University of Oxford, UK.
Br J Cancer. 1999 Feb;79(3-4):658-65. doi: 10.1038/sj.bjc.6690104.
We report a population-based study of patterns of care and survival for people with acute leukaemia diagnosed at age 15-29 years during 1984-94 in regions of England and Wales covered by specialist leukaemia registries. There were 879 patients: 417 with acute lymphoblastic leukaemia (ALL) and 462 with acute myeloid leukaemia (AML). For ALL, actuarial survival rates were 43% at 5 years after diagnosis and 37% at 10 years. Survival improved significantly between 1984-88 and 1989-94 for those aged 15-19 at diagnosis. Patients entered in national clinical trials and those not entered had similar survival rates. Survival rates were similar at teaching and non-teaching hospitals and at hospitals treating different numbers of study patients per year. For AML, survival rates were 42% at 5 years after diagnosis and 39% at 10 years. Survival improved significantly between 1984-88 and 1989-94. Patients entered in the Medical Research Council AML10 trial had a higher survival rate than those who were in the earlier AML9 trial. Survival did not vary with category of hospital. We conclude that survival has improved for adolescents and young adults with acute leukaemia but that there is at present no evidence that centralized treatment results in a survival benefit for patients in this age group.
我们报告了一项基于人群的研究，该研究针对1984年至1994年间在英格兰和威尔士有专科白血病登记处覆盖地区确诊的15至29岁急性白血病患者的护理模式和生存率。共有879名患者：417例急性淋巴细胞白血病（ALL）患者和462例急性髓细胞白血病（AML）患者。对于ALL，确诊后5年的精算生存率为43%，10年为37%。对于确诊时年龄在15至19岁的患者，1984 - 1988年和1989 - 1994年期间生存率有显著提高。参加国家临床试验的患者和未参加的患者生存率相似。教学医院和非教学医院以及每年治疗不同数量研究患者的医院的生存率相似。对于AML，确诊后5年的生存率为42%，10年为39%。1984 - 1988年和1989 - 1994年期间生存率有显著提高。参加医学研究委员会AML10试验的患者比参加早期AML9试验的患者生存率更高。生存率不因医院类别而异。我们得出结论，青少年和年轻成人急性白血病患者的生存率有所提高，但目前没有证据表明集中治疗能使该年龄组患者获得生存益处。
