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在东京儿童癌症研究组(TCCSG)临床试验中接受治疗的青少年急性淋巴细胞白血病的治疗结果。

Treatment outcomes of adolescent acute lymphoblastic leukemia treated on Tokyo Children's Cancer Study Group (TCCSG) clinical trials.

作者信息

Kato Motohiro, Manabe Atsushi, Koh Katsuyoshi, Inukai Takeshi, Kiyokawa Nobutaka, Fukushima Takashi, Goto Hiroaki, Hasegawa Daisuke, Ogawa Chitose, Koike Kazutoshi, Ota Setsuo, Noguchi Yasushi, Kikuchi Akira, Tsuchida Masahiro, Ohara Akira

机构信息

Department of Pediatrics, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan,

出版信息

Int J Hematol. 2014 Aug;100(2):180-7. doi: 10.1007/s12185-014-1622-y. Epub 2014 Jun 18.

Abstract

There is no standard treatment for adolescents aged 15 years or older with acute lymphoblastic leukemia (ALL), although this age group has been reported as having a poorer prognosis compared to younger patients. We retrospectively analyzed the outcomes of three consecutive Tokyo Children's Cancer Study Group ALL trials (1995-2006) of 373 patients aged 10 years or older, with particular focus on adolescents aged 15-18 years (older-adolescents n = 41), compared to those aged 10-14 years (younger-adolescents n = 332). The probability of event-free survival at 8 years was 67.5 ± 7.4 % for the older-adolescents and 66.5 ± 2.6 % for the younger-adolescents (p = 0.95). Overall survival was 70.7 ± 7.1 % for the older-adolescents and 74.3 ± 2.4 % for the younger-adolescents (p = 0.48). The differences between groups in relapse incidence, non-relapse mortality, and death rate during induction were not statistically significant, although the older-adolescents trended towards a higher frequency of having stem-cell transplantation during the first remission. In conclusion, our treatment strategy, which consists of intensive induction and block-type consolidation, provided improved outcomes for patients aged 15-18 years, comparable to those for patients aged 10-14 years.

摘要

对于15岁及以上的急性淋巴细胞白血病(ALL)青少年患者,目前尚无标准治疗方案,尽管据报道该年龄组的预后比年轻患者更差。我们回顾性分析了东京儿童癌症研究组连续三项ALL试验(1995 - 2006年)中373例10岁及以上患者的治疗结果,特别关注15 - 18岁的青少年(大龄青少年n = 41),并与10 - 14岁的青少年(小龄青少年n = 332)进行比较。大龄青少年8年无事件生存率为67.5 ± 7.4%,小龄青少年为66.5 ± 2.6%(p = 0.95)。大龄青少年总生存率为70.7 ± 7.1%,小龄青少年为74.3 ± 2.4%(p = 0.48)。尽管大龄青少年在首次缓解期进行干细胞移植的频率有升高趋势,但两组在复发率、非复发死亡率和诱导期死亡率方面的差异无统计学意义。总之,我们由强化诱导和分段式巩固组成的治疗策略为15 - 18岁患者带来了改善的治疗结果,与10 - 14岁患者相当。

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