Wang Kai-Ling, Mei Yan-Yan, Cui Lei, Gao Chao, Liu Fei-Fei, Zhao Xiao-Xi, Li Wei-Jing, Jiang Jin, Zhang Rui-Dong, Xie Jing, Shi Hui-Wen, Wang Bin, Zhang Yong-Hong, Ma Xiao-Li, Wu Min-Yuan, Zhou Xuan, Li Zhi-Gang
Hematology Oncology Center, Beijing Key Laboratory of Pediatric Hematology and Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics; Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
Hematology Oncology Center, Beijing Key Laboratory of Pediatric Hematology and Oncology; Key Laboratory of Major Diseases in Children, Ministry of Education; National Key Discipline of Pediatrics; Beijing Children's Hospital, Capital Medical University, Beijing 100045, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2014 Apr;22(2):285-90. doi: 10.7534/j.issn.1009-2137.2014.02.005.
This study was aimed to compare the curative effect of BCH - 2003 protocol and CCLG - 2008 protocol for children with TEL-AML1 fusion gene positive childhood acute lymphoblastic leukemia (ALL) and to investigate the more suitable protocol for this subtype of childhood leukemia. The clinical data for children with TEL-AML1 fusion gene positive ALL admitted from January 2003 to October 2010 in Hematology Center of Beijing Children's Hospital were collected. The common clinical characteristics including prednisone response at day 8, minimal residual disease (MRD) at the end of induction of remission (day 33), event free survival (EFS), relapse free survival (RFS) were compared. The results showed that out of 204 children with TEL-AML1 fusion gene positive ALL, 134 and 70 patients were treated by BCH-2003 protocol and CCLG-2008 protocol respectively. There were no statistical difference in age, white blood cell count in peripheral blood at presentation, prednisone response and CNS involvement. However, there were more boys in CCLG-2008 group (P = 0.025). The negative rate of MRD at day 33 in BCH-2003 group was lower than that in CCLG-2008 group (P = 0.013). After re-stratifying the patients in CCLG-2008 group according to the stratification criteria of BCH-2003 protocol, the negative rate of MRD at day 33 of patients with intermediate risk remained higher in BCH-2003 group than that in CCLG-2008 group (P = 0.014) . However, no significant difference in the patients with standard risk was found. There were also no significant statistical differences in the incidence of severe infection, EFS and RFS, (P = 1.000, P = 0.327,P = 0.251 respectively) during chemotherapy. It is concluded that for children with TEL-AML1 fusion gene positive ALL, the induction of remission of BCH - 2003 protocol can decrease leukemic load more quickly than that of CCLG - 2008 protocol. However, the outcome of the patients treated by the two protocols is similar.
本研究旨在比较BCH - 2003方案与CCLG - 2008方案对TEL-AML1融合基因阳性儿童急性淋巴细胞白血病（ALL）的疗效，并探讨更适合该亚型儿童白血病的方案。收集了2003年1月至2010年10月在北京儿童医院血液中心收治的TEL-AML1融合基因阳性ALL患儿的临床资料。比较了常见的临床特征，包括第8天的泼尼松反应、诱导缓解结束时（第33天）的微小残留病（MRD）、无事件生存（EFS）、无复发生存（RFS）。结果显示，在204例TEL-AML1融合基因阳性ALL患儿中，分别有134例和70例采用BCH-2003方案和CCLG-2008方案治疗。两组在年龄、初诊时外周血白细胞计数、泼尼松反应和中枢神经系统受累情况方面无统计学差异。然而，CCLG-2008组男孩更多（P = 0.025）。BCH-2003组第33天MRD阴性率低于CCLG-2008组（P = 0.013）。按照BCH-2003方案的分层标准对CCLG-2008组患者重新分层后，中危患者第33天MRD阴性率在BCH-2003组仍高于CCLG-2008组（P = 0.014）。然而，低危患者之间未发现显著差异。化疗期间严重感染发生率、EFS和RFS也无显著统计学差异（分别为P = 1.000、P = 0.327、P = 0.251）。结论是，对于TEL-AML1融合基因阳性ALL患儿，BCH - 2003方案诱导缓解比CCLG - 2008方案能更快降低白血病负荷。然而，两种方案治疗患者的结局相似。
