Hafez Hanafy A, Soliaman Rawaa M, Bilal Dalia, Hashem Mohamed, Shalaby Lobna M
Departments of Pediatric Oncology.
Department of Pediatric Oncology.
J Pediatr Hematol Oncol. 2019 May;41(4):261-266. doi: 10.1097/MPH.0000000000001408.
Children with acute leukemia may experience high treatment-related mortality, which often occurs early in the induction phase. The aim of the study was to assess the incidence and risk factors related to increased mortality during induction therapy of pediatric patients with acute leukemia. This is a retrospective study that included pediatric acute leukemia patients who presented to the National Cancer Institute, Cairo University, between January 2011 and December 2013. The study included 370 patients, 253 with acute lymphoblastic leukemia, 100 with acute myeloid leukemia, and 17 with mixed phenotype acute leukemia. The total and induction death rates were 40.5% and 19.2%, respectively. Most of the early deaths were attributed to infections (64.7%) and cerebrovascular accidents (18.3%). Using enhanced supportive care measures during 2013 had significantly reduced the overall and induction mortality rates (29% and 13.6%, respectively, in 2013 vs. 46% and 20.3% in 2011). Induction deaths in pediatric acute leukemia remain a major challenge in developing countries, and using enhanced supportive care measures is effective to improve the survival outcome in this group of patients.
患有急性白血病的儿童可能会面临较高的与治疗相关的死亡率，这通常发生在诱导缓解期的早期。本研究的目的是评估小儿急性白血病患者诱导缓解治疗期间死亡率增加的发生率及相关危险因素。这是一项回顾性研究，纳入了2011年1月至2013年12月期间在开罗大学国家癌症研究所就诊的小儿急性白血病患者。该研究包括370例患者，其中253例为急性淋巴细胞白血病，100例为急性髓细胞白血病，17例为混合表型急性白血病。总死亡率和诱导缓解期死亡率分别为40.5%和19.2%。大多数早期死亡归因于感染（64.7%）和脑血管意外（18.3%）。2013年采用强化支持治疗措施显著降低了总死亡率和诱导缓解期死亡率（2013年分别为29%和13.6%，而2011年为46%和20.3%）。在发展中国家，小儿急性白血病的诱导缓解期死亡仍然是一个重大挑战，采用强化支持治疗措施可有效改善这组患者的生存结局。
