Michel G, Maraninchi D, Thuret I, Fay C, Guitard A M, Mozziconacci M J, Novakovitch G, Capodano A M, Tubiana N, Perrimond H
Service d'Hématologie Pédiatrique, Hôpital d'Enfants La Timone, Marseille.
Arch Fr Pediatr. 1990 Mar;47(3):163-8.
Ninety-two previously untreated children with ALL were admitted to the same institution between November 1984 and November 1988. According to early prognostic factors, patients were divided into 3 groups: group 1 at "low risk" for relapse (n = 18), group 2 at "intermediate risk" (n = 62) and group 3 at "high risk" (n = 12). Every patient received an 8 week-long induction chemotherapy; after CNS prophylaxis, groups 1 and 2 children received a consolidation chemotherapy and then a classical maintenance treatment. Group 3 patients were selected to receive a bone-marrow transplantation during their first remission because of the presence, at diagnosis, of at least one of the following criteria: hyperleukocytosis greater than 100,000 (7 cases), translocation t(1;19) and t(4;11) (2 cases), adolescents (2 cases), no remission at day 30 (2 cases). Ninety-one of 92 children achieved a complete remission and none died during induction therapy. Probability of leukemia-free survival at 4 years is 73 +/- 7% for the whole patient population and 95%, 71% and 60% for patients of groups 1, 2, and 3 respectively. Persistence or disappearance of leukaemic cells in bone marrow after the initial 15 days of chemotherapy appears to influence the probability of a leukemia-free survival.
1984年11月至1988年11月期间，92名先前未经治疗的急性淋巴细胞白血病患儿被收治于同一机构。根据早期预后因素，患者被分为3组：1组为复发“低风险”组（n = 18），2组为“中度风险”组（n = 62），3组为“高风险”组（n = 12）。每名患者均接受为期8周的诱导化疗；在进行中枢神经系统预防后，1组和2组患儿接受巩固化疗，然后进行经典的维持治疗。3组患者因在诊断时存在以下至少一项标准而被选择在首次缓解期接受骨髓移植：白细胞增多超过100,000（7例）、t(1;19)和t(4;11)易位（2例）、青少年（2例）、第30天未缓解（2例）。92名患儿中有91名实现完全缓解，诱导治疗期间无死亡病例。整个患者群体4年无白血病生存率为73±7%，1组、2组和3组患者分别为95%、71%和60%。化疗开始15天后骨髓中白血病细胞的持续存在或消失似乎会影响无白血病生存的概率。
