通过强化巩固治疗和造血干细胞移植改善儿童急性淋巴细胞白血病的预后。
Improved outcome in childhood ALL with intensive consolidation and hematopoietic stem cell transplant.
作者信息
Park Jeong A, Ghim Thad, Bae Keun Wook, Koh Kyung Nam, Im Ho Joon, Seo Jong Jin
机构信息
Department of Pediatric, Inje University Haeundae Baik Hospital, Inje University College of Medicine, Busan, Korea.
出版信息
Korean J Hematol. 2010 Jun;45(2):109-14. doi: 10.5045/kjh.2010.45.2.109. Epub 2010 Jun 30.
BACKGROUND
Despite advances in chemotherapy, the prognosis of relapsed acute lymphoblastic leukemia (ALL) remains poor. Few studies on relapsed ALL have reported the importance of intensive consolidation followed with or without allogeneic hematopoietic stem cell transplantation (HSCT).
METHODS
We evaluated the post-relapse outcomes in 47 Korean children with a first marrow relapse, and analyzed the prognostic factors.
RESULTS
A second complete remission (CR) was achieved in 40 patients (85.1%), and at the time of this study, second CR was maintained in 12 of these patients. The estimated 3-yr event-free survival (EFS) rate after the first marrow relapse was 29.8±6.7%, and the overall survival (OS) rate was 45.3±7.5%. We found that second remission, consolidation of pediatric oncology group chemotherapy regimen (POG 9411), and HSCT significantly affected the outcome of the disease after relapse (P<0.001; P=0.004; P=0.05).
CONCLUSION
The results of our study revealed that an intensified POG 9411 consolidation chemotherapy regimen followed by HSCT can improve the outcome of patients with relapsed ALL.
背景
尽管化疗取得了进展，但复发的急性淋巴细胞白血病（ALL）的预后仍然很差。关于复发ALL的研究很少报道强化巩固治疗（无论是否进行异基因造血干细胞移植（HSCT））的重要性。
方法
我们评估了47例首次骨髓复发的韩国儿童复发后的结局，并分析了预后因素。
结果
40例患者（85.1%）实现了第二次完全缓解（CR），在本研究时，其中12例患者维持第二次CR。首次骨髓复发后的估计3年无事件生存率（EFS）为29.8±6.7%，总生存率（OS）为45.3±7.5%。我们发现第二次缓解、儿科肿瘤学组化疗方案（POG 9411）的巩固治疗以及HSCT对复发后疾病的结局有显著影响（P<0.001；P=0.004；P=0.05）。
结论
我们的研究结果表明，强化的POG 9411巩固化疗方案联合HSCT可改善复发ALL患者的结局。
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