Yan Pei-Hua, Yan Mei, Wang Xue-Mei, Wang Shu-Hong
Department of Pediatrics, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2014 Feb;16(2):141-6.
To investigate the effect of Huangqi injection on the short-term prognosis in childhood with acute lymphoblastic leukemia (ALL).
A retrospective analysis was performed on the clinical data of 105 children newly diagnosed with ALL between January 2009 and December 2012. These children were randomly divided into treatment group (18 low-risk cases, 7 medium-risk cases, and 24 high-risk cases) and control group (21 low-risk cases, 7 medium-risk cases, 28 high-risk cases). Both groups were given remission induction therapy based on the levels of risk. Throughout the remission induction therapy, the treatment group also received Huangqi injection (0.5-1.0 mL/kg per day) by intravenous infusion, while the control group was given 0.9% sodium chloride injection instead. The two groups were compared in terms of distribution of prognostic factors and complete remission (CR) rate after remission induction therapy, as well as the incidence of minimal residual disease (MDR) (≥ 10(-4) and < 10(-4)) among all patients in the two groups on day 19 of remission induction therapy and among B-ALL patients in the two groups when achieving a CR at the end of remission induction therapy.
Of the 105 children with ALL, 99 had B-ALL, and 6 had T-ALL. There were no significant differences in the distribution of prognostic factors between the two groups (P>0.05). The overall CR rate of 105 patients was 79%; there was no significant difference in CR rate between the treatment and control groups (82% vs 77%; P>0.05); also, no significant differences were found between the two groups in the CR rates among high-, medium-, and low-risk cases (P>0.05). On day 19 of remission induction therapy, the incidence of MRD≥10(-4) in the treatment group was significantly lower than that in the control group (69% vs 95%; P<0.05); among 80 children with B-ALL who achieved a CR (43 cases in the control group and 37 cases in the treatment group), the incidence of MRD≥10-4 was significantly lower in the treatment group than in the control group (27% vs 58%; P<0.05); in both circumstances above, the high- and low-risk cases in the treatment group had a significantly lower incidence of MRD≥10(-4) than the control group (P<0.05).
Huangqi injection combined with chemotherapy has an enhanced anti-tumor effect and can improve the short-term prognosis and clinical outcome in children with ALL.
探讨黄芪注射液对儿童急性淋巴细胞白血病(ALL)短期预后的影响。
对2009年1月至2012年12月期间新诊断的105例ALL患儿的临床资料进行回顾性分析。将这些患儿随机分为治疗组(低危18例、中危7例、高危24例)和对照组(低危21例、中危7例、高危28例)。两组均根据危险度分层给予诱导缓解治疗。在整个诱导缓解治疗过程中,治疗组还静脉输注黄芪注射液(0.5 - 1.0 mL/kg每日),而对照组给予0.9%氯化钠注射液。比较两组预后因素分布、诱导缓解治疗后的完全缓解(CR)率,以及诱导缓解治疗第19天时两组所有患者中微小残留病(MDR)(≥10⁻⁴和<10⁻⁴)的发生率,以及诱导缓解治疗结束达到CR时两组B - ALL患者中MDR的发生率。
105例ALL患儿中,99例为B - ALL,6例为T - ALL。两组预后因素分布无显著差异(P>0.05)。105例患者的总体CR率为79%;治疗组与对照组的CR率无显著差异(82%对77%;P>0.05);高、中、低危病例组间CR率在两组中也无显著差异(P>0.对5)。诱导缓解治疗第19天时,治疗组MRD≥10⁻⁴的发生率显著低于对照组(69%对95%;P<0.05);在80例达到CR的B - ALL患儿中(对照组43例,治疗组37例),治疗组MRD≥10⁻⁴的发生率显著低于对照组(27%对58%;P<0.05);在上述两种情况下,治疗组的高、低危病例中MRD≥10⁻⁴的发生率均显著低于对照组(P<0.05)。
黄芪注射液联合化疗具有增强的抗肿瘤作用,可改善ALL患儿的短期预后和临床结局。