CCLG-ALL2008方案治疗10岁以上儿童及青少年急性淋巴细胞白血病的临床疗效
[Clinical effect of CCLG-ALL2008 regimen in treatment of children and adolescents aged >10 years with acute lymphoblastic leukemia].
作者信息
Lan Yang, Chen Xiao-Juan, Zou Yao, Ruan Min, Zhu Xiao-Fan
机构信息
Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2019 May;21(5):405-410. doi: 10.7499/j.issn.1008-8830.2019.05.001.
OBJECTIVE
To study the long-term clinical effect of CCLG-ALL2008 regimen in the treatment of children and adolescents, aged >10 years, with newly diagnosed acute lymphoblastic leukemia (ALL).
METHODS
A retrospective analysis was performed for the clinical data of 150 ALL children and adolescents aged >10 years who were treated with CCLG-ALL2008 regimen from April 2008 to April 2015. The Kaplan-Meier method was used to analyze overall survival (OS) rate and event-free survival (EFS) rate.
RESULTS
Among the 150 children and adolescents, there were 87 (58.0%) boys and 63 (42.0%) girls, with a median age of 11 years (range 10-15 years). Of the 150 children and adolescents, 84 (56.0%) had intermediate risk and 66 (44.0%) had high risk; 122 (81.3%) had B-lineage acute lymphoblastic leukemia (B-ALL) and 28 (18.7%) had T-lineage acute lymphoblastic leukemia (T-ALL). The fusion gene test yielded positive results in 51 children and adolescents (34.0%), among whom 16 (31%) had positive BCR-ABL, 11 (22%) had positive TEL-AML1, 8 (16%) had positive E2A-PBX1, and 16 (31%) were positive for other fusion genes. The complete remission rate was 96.0% (144/150) after one course of treatment with CCLG-ALL2008 regimen. The median follow-up time was 52 months (range 3-122 months). The 5-year OS rate was 79.0%±3.5%, and the 5-year EFS rate was 67.3%±4.1%. There were no significant differences in 5-year OS and EFS rates between the children with intermediate or high risk, as well as between the children with B-ALL or T-ALL (P>0.05). The children and adolescents who achieved complete remission of bone marrow at the end of induction therapy had significantly higher 5-year OS and EFS rates than those who did not achieve complete remission (P<0.05).
CONCLUSIONS
In ALL children and adolescents aged >10 years, CCLG-ALL2008 regimen can help to achieve high complete remission rate, 5-year OS rate and 5-year EFS rate. The children and adolescents failing to achieve complete remission at the end of induction therapy tend to have a poor prognosis.
目的
探讨CCLG-ALL2008方案治疗10岁以上新诊断急性淋巴细胞白血病（ALL）儿童及青少年的长期临床疗效。
方法
回顾性分析2008年4月至2015年4月采用CCLG-ALL2008方案治疗的150例10岁以上ALL儿童及青少年的临床资料。采用Kaplan-Meier法分析总生存率（OS）和无事件生存率（EFS）。
结果
150例儿童及青少年中，男87例（58.0%），女63例（42.0%），中位年龄11岁（范围10 - 15岁）。150例儿童及青少年中，84例（56.0%）为中危，66例（44.0%）为高危；122例（81.3%）为B系急性淋巴细胞白血病（B-ALL），28例（18.7%）为T系急性淋巴细胞白血病（T-ALL）。融合基因检测51例儿童及青少年（34.0%）结果为阳性，其中16例（31%）BCR-ABL阳性，11例（22%）TEL-AML1阳性，8例（16%）E2A-PBX1阳性，16例（31%）其他融合基因阳性。采用CCLG-ALL2008方案治疗1个疗程后完全缓解率为96.0%（144/150）。中位随访时间52个月（范围3 - 122个月）。5年OS率为79.0%±3.5%，5年EFS率为67.3%±4.1%。中危或高危儿童以及B-ALL或T-ALL儿童的5年OS率和EFS率差异无统计学意义（P>0.05）。诱导治疗结束时骨髓达到完全缓解的儿童及青少年5年OS率和EFS率显著高于未达到完全缓解者（P<0.05）。
结论
对于10岁以上ALL儿童及青少年，CCLG-ALL2008方案可使完全缓解率、5年OS率和5年EFS率较高。诱导治疗结束时未达到完全缓解的儿童及青少年预后往往较差。
Zotero 插件