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在摩洛哥卡萨布兰卡采用统一方案治疗的儿童、青少年和青年急性髓系白血病的治疗结果

Outcome of Acute Myeloid Leukemia in Children Adolescents and Young Adults Treated with an Uniform Protocol in Casablanca, Morocco.

作者信息

Housou B, Cherkaoui S, Lamchahab M, Massi R, Khoubila N, Qachouh M, Rachid M, Madani A, Athale U H, Quessar A

机构信息

1Department of Hematology and Pediatric Oncology, Hospital 20 August, University Hassan II Casablanca, Casablanca, Morocco.

3Clinical Hematology and Pediatric Oncology Department, Hospital 20 August, CHU Ibn Rochd, 20250 Casablanca, Morocco.

出版信息

Indian J Hematol Blood Transfus. 2019 Apr;35(2):255-259. doi: 10.1007/s12288-018-1013-2. Epub 2018 Sep 25.

Abstract

Treatment of acute myeloblastic leukemia in children, adolescents and young adults (AYA) is a challenge in low-income countries. To evaluate treatment outcomes of children (≤ 15 years) and AYA (15-30 years) diagnosed with novo AML and treated in a single center according to the AML-MA 2011 protocol. From January 2011 to December 2015, eligible patients (age ≤ 30 years) with novo AML had been enrolled on a uniform treatment protocol. The diagnosis was confirmed according to the FAB classification using the WHO 2008 criteria. Patients with WBC ≥ 50 G/L had pretreated 4 days of hydroxyurea followed by two inductions and two consolidations. Supportive care consisted of transfusion of labile blood products, antibiotics and antifungals, and patient and family education by the hygiene team. 155 patients were recruited, 41 were < 15 years old (22 boys, median age 7.8 years). Of the 114 AYA enrolled, (48 women, median age 23 years). Complete remission after two inductions was 28/41 (68.3%) of the children, including 100% of the children in the favorable group and 71/114 (62.3%) of the AYA, 22 of whom (68.7%) were in the favorable group. The number of deaths among children was 6 (14.6%). The evaluation of the AML-MA-2011 National Protocol in the age groups of children and AYA reveals that the objective of treatment is almost achieved in terms of complete remission in the two age groups.

摘要

在低收入国家,治疗儿童、青少年和青年成人(AYA)的急性髓细胞白血病是一项挑战。为了评估根据2011年AML-MA方案在单一中心诊断并治疗的初发急性髓系白血病(AML)儿童(≤15岁)和AYA(15 - 30岁)的治疗结果。2011年1月至2015年12月,符合条件的初发AML患者(年龄≤30岁)纳入统一治疗方案。根据2008年世界卫生组织标准的FAB分类确诊。白细胞计数≥50×10⁹/L的患者先接受4天羟基脲预处理,然后进行两次诱导和两次巩固治疗。支持性治疗包括输注不稳定血液制品、使用抗生素和抗真菌药物,以及由卫生团队对患者及其家属进行教育。共招募了155名患者,其中41名年龄<15岁(22名男孩,中位年龄7.8岁)。在纳入的114名AYA中,(48名女性,中位年龄23岁)。两次诱导后儿童的完全缓解率为28/41(68.3%),其中有利组儿童的完全缓解率为100%;AYA的完全缓解率为71/114(62.3%),其中22名(68.7%)在有利组。儿童死亡人数为6人(14.6%)。对儿童和AYA年龄组的2011年AML-MA国家方案的评估表明,就两个年龄组的完全缓解而言,治疗目标几乎实现。

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本文引用的文献

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