[采用大剂量甲氨蝶呤（5.0 g/m²）治疗儿童标准风险急性淋巴细胞白血病的结果。波兰儿童白血病/淋巴瘤研究组11年的经验]

[Treatment results in children with the standard risk acute lymphoblastic leukemia treated with high dose of methotrexate (5.0 g/m2). 11 years of the Polish Pediatric Leukemia/Lymphoma Study Group experience].

作者信息

Derwich Katarzyna, Wachowiaki Jacek, Kaczmarek-Kanoldi Małgorzata, Balcerska Anna, Balwierz Walentyna, Chybicka Alicja, Kowalczyk Jerzy R, Matysiak Michał, Jackowska Teresa, Sońta-Jakimczyk Danuta, Wysocki Mariusz, Chełmecka-Hanuszewicz Lidia, Cwiklińska Magdalena, Kołtan Andrzej, Malinowska Iwona, Odój Teresa, Płoszyńska Anna, Steczowicz Monika, Wojciechowska Violeta, Wójtowicz Anna

机构信息

Klinika Onkologii, Hematologii i Transplantologii Pediatrycznej, II Katedry Pediatrii AM 60-572 Poznań, ul. Szpitalna 27/33.

出版信息

Przegl Lek. 2006;63(1):7-10.

PMID:16892891

Abstract

Since 01.07.1993 to 30.09.2004, 675 children with ALL-SR were diagnosed and treated according to the modified ALL-BFM 90 protocol. Subject to statistical analysis (Kaplan-Meier method) were thus 197 children with ALL-SR treated with HD-MTX in a dose 5.0g/ m2. Among them, 21 patients failed to respond to therapy: 2 (1.0%) early deaths, 2 (1.0%) deaths during I complete remission, 16 (8.2%) relapses, 1 (0.5%) second neoplasm. Relapses occured: 12 (6.2%) in bone marrow, 2 (1.0%) in central nervous system, 1 (0.5%) in testicle and in 1 (0.5%) child combined relapse was observed. Probability rates for 11-year event free survival (EFS) was 0.80 (0.03). Application of high dose of methotrexate is safety and effective in prevention of relapses, especially meningeal and testicular involvement.

摘要

自1993年7月1日至2004年9月30日，675例急性淋巴细胞白血病标准化风险（ALL-SR）患儿根据改良的ALL-BFM 90方案进行诊断和治疗。因此，对197例接受5.0g/m²剂量大剂量甲氨蝶呤（HD-MTX）治疗的ALL-SR患儿进行了统计分析（Kaplan-Meier法）。其中，21例患者治疗无效：2例（1.0%）早期死亡，2例（1.0%）在首次完全缓解期死亡，16例（8.2%）复发，1例（0.5%）发生第二肿瘤。复发情况如下：12例（6.2%）发生在骨髓，2例（1.0%）发生在中枢神经系统，1例（0.5%）发生在睾丸，1例（0.5%）患儿出现联合复发。11年无事件生存率（EFS）概率为0.80（0.03）。大剂量甲氨蝶呤的应用在预防复发方面安全有效，尤其是预防脑膜和睾丸受累。