Yeoh Amelia, Collins Anna, Fox Kahlia, Shields Sarah, Ritchie Petra, Kirby Maria, Revesz Tamas
a Discipline of Paediatrics , University of Adelaide , Adelaide , South Australia , Australia.
b Department of Haematology-Oncology , Women's and Children's Hospital , Adelaide , South Australia , Australia.
Pediatr Hematol Oncol. 2017 Feb;34(1):38-42. doi: 10.1080/08880018.2016.1276235. Epub 2017 Mar 13.
Delays or interruptions in chemotherapy due to toxicity such as neutropenia or severe infections are common in the treatment of pediatric acute lymphoblastic leukemia (ALL). Based on the reports of worse outcomes in children with poorer compliance with therapy, there has been concern that toxicity-induced therapy interruptions could also compromise treatment outcome. In a retrospective study of treatment delays in our hospital between 2003 and 2013, the case notes of 141 patients were reviewed. The cumulative lengths of delays during the whole length of chemotherapy, during the intensive phase of treatment, and during maintenance treatment were analyzed. Within these categories, delays were split between less and more than the median value. The risk of relapse did not differ between patients with a longer or shorter delay during the total length of treatment or during the intensive phase. In addition, there was a trend when comparing patients above vs below the mean in length of treatment delays during maintenance, and there was a statistically significant difference in relapses when comparing patients in the lowest and highest quartiles of maintenance delays, with fewer relapses among those patients in the highest quartile for treatment delays.
在小儿急性淋巴细胞白血病（ALL）的治疗中，由于诸如中性粒细胞减少或严重感染等毒性导致化疗延迟或中断的情况很常见。基于对治疗依从性较差的儿童预后更差的报道，人们担心毒性引起的治疗中断也可能影响治疗效果。在一项对我院2003年至2013年期间治疗延迟情况的回顾性研究中，对141例患者的病历进行了审查。分析了化疗全过程、强化治疗阶段和维持治疗阶段延迟的累计时长。在这些类别中，延迟被分为低于和高于中位数。在治疗总时长或强化治疗阶段延迟时间较长或较短的患者之间，复发风险没有差异。此外，在比较维持治疗期间治疗延迟时长高于或低于平均值的患者时存在一种趋势，并且在比较维持延迟时长处于最低和最高四分位数的患者时，复发率存在统计学上的显著差异，治疗延迟时长处于最高四分位数的患者复发较少。
