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丹麦10至19岁青少年急性淋巴细胞白血病——二次发表

Acute lymphoblastic leukemia in adolescents between 10 and 19 years of age in Denmark--secondary publication.

作者信息

Schrøder H, Kjeldahl M, Boesen A M, Nielsen O J, Schmidt K, Johnsen H E, Gregersen H, Heyman M, Gustafsson G

机构信息

Department of Pediatrics, University Hospital of Aarhus, Skejby Hospital, Aarhus, Denmark.

出版信息

Dan Med Bull. 2006 Feb;53(1):76-9.

Abstract

INTRODUCTION

Data seem to indicate that young adults with acute lymphoblastic leukemia (ALL) have a better survival when treated with pediatric protocols compared with adult ALL protocols. The purpose of the study was to report the clinical characteristics and outcome of all children and young adults 10-19 years of age diagnosed with ALL in Denmark between 1992 and 2001.

MATERIAL

The study includes 99 patients 10-19 years of age with ALL in Denmark during a ten year period found in the complete NOPHO (Nordic Society of Pediatric Hematology and Oncology) registry and through the Danish Cancer Registry and local pathology databases. Data were retrieved by reviewing medical charts of the patients. A total of 61 children (10-14 years) treated on pediatric protocols and 38 young adults (15-19 years) were diagnosed with ALL. Data were reported as of January 1st 2005.

RESULTS

There were no difference with respect to the distribution of T-ALL, CNS-leukemia, total white blood count and high risk chromosomal abnormalities between the two groups. There was a statistical significant lower event free survival (p<0.01) and lower overall survival (p<0.01) in young adults compared with 10-14 year-old children (0.38 vs 0.60 and 0.47 vs 0.67). There were more transplant-related deaths in the young adults. Higher treatment intensity in children may be an additional explanatory factor. Children received more prednisone, vincristine and high-dose methotrexate than young adults.

CONCLUSION

Young adult patients with ALL might benefit from therapy with pediatric NOPHO ALL protocols.

摘要

引言

数据似乎表明,与成人急性淋巴细胞白血病(ALL)治疗方案相比,采用儿童治疗方案治疗的年轻成人ALL患者生存率更高。本研究的目的是报告1992年至2001年期间在丹麦诊断为ALL的所有10至19岁儿童和年轻成人的临床特征及预后。

材料

本研究纳入了丹麦10至19岁的99例ALL患者,这些患者是在完整的北欧儿科血液学和肿瘤学会(NOPHO)登记处以及丹麦癌症登记处和当地病理数据库中发现的,为期十年。通过查阅患者的病历获取数据。共有61名(10至14岁)采用儿童治疗方案治疗的儿童和38名(15至19岁)年轻成人被诊断为ALL。数据截至2005年1月1日。

结果

两组在T-ALL、中枢神经系统白血病、白细胞总数和高危染色体异常的分布方面无差异。与10至14岁儿童相比,年轻成人的无事件生存率(p<0.01)和总生存率(p<0.01)显著更低(分别为0.38对0.60和0.47对0.67)。年轻成人中与移植相关的死亡更多。儿童更高的治疗强度可能是另一个解释因素。儿童比年轻成人接受了更多的泼尼松、长春新碱和大剂量甲氨蝶呤。

结论

年轻成人ALL患者可能从儿童NOPHO ALL治疗方案中获益。

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