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顺化中央医院10年(2008 - 2018年)儿童急性淋巴细胞白血病的死亡原因

Causes of Death in Childhood Acute Lymphoblastic Leukemia at Hue Central Hospital for 10 Years (2008-2018).

作者信息

Kiem Hao Tran, Nhu Hiep Pham, Kim Hoa Nguyen Thi, Van Ha Chau

机构信息

Pediatric Center, Hue Central Hospital, Vietnam.

出版信息

Glob Pediatr Health. 2020 Jan 22;7:2333794X20901930. doi: 10.1177/2333794X20901930. eCollection 2020.

Abstract

. To analyze the common cause of death in childhood acute lymphoblastic leukemia patients. . A retrospective descriptive study on children with acute lymphoblastic leukemia who died at Hue Central Hospital between 2008 and 2018. All the patients were treated with the same protocol of modified Children's Cancer Group 1882 and 1881. . A total of 238 children with acute lymphoblastic leukemia who were cared for at our center were enrolled. Of these, there were 74 deaths. Among the death group, the male-to-female ratio was 2.7:1. Twenty-six (35.1%) occurred in maintenance phase, 18 (24.3%) occurred in induction phase, and 9 (12.2%) occurred in delayed intensification. Infection was responsible for deaths in 32 of 74 (43.2%) cases. was found in 3 of 32 infected cases (9.4%) and resistance to almost all antibiotics in our hospital. Relapse, abandonment, and bleeding were documented in 20 (27.0%), 7 (9.5%), and 6 (8.1%) cases, respectively. Twenty-seven (84.3%) patients had absolute neutrophil count <500/µL. Of 32 infectious deaths, pneumonia occurred in 40.6%. Regarding 20 relapse death, bone marrow was the major site of relapse and it occurred in 13 (65%) cases. And there were 65% patients with very early relapse. . Infection is the major cause of mortality in acute lymphoblastic leukemia patients in our study. To improve outcome, we should improve supportive care, especially prevention and control infection.

摘要

分析儿童急性淋巴细胞白血病患者的常见死亡原因。对2008年至2018年期间在顺化中央医院死亡的急性淋巴细胞白血病患儿进行回顾性描述性研究。所有患者均采用改良的儿童癌症组1882和1881方案进行治疗。我们中心共纳入了238例接受治疗的急性淋巴细胞白血病患儿。其中,74例死亡。在死亡组中,男女比例为2.7:1。26例(35.1%)发生在维持期,18例(24.3%)发生在诱导期,9例(12.2%)发生在延迟强化期。74例中有32例(43.2%)的死亡原因是感染。在32例感染病例中有3例(9.4%)检测到[此处原文缺失相关内容],且对我院几乎所有抗生素耐药。分别有20例(27.0%)、7例(9.5%)和6例(8.1%)记录有复发、放弃治疗和出血情况。27例(84.3%)患者的绝对中性粒细胞计数<500/µL。在32例感染性死亡病例中,肺炎占40.6%。在20例复发死亡病例中,骨髓是主要复发部位,有13例(65%)。且有65%的患者复发非常早。在我们的研究中,感染是急性淋巴细胞白血病患者死亡的主要原因。为改善治疗结果,我们应加强支持治疗,尤其是预防和控制感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/694a/6977218/86857584d64e/10.1177_2333794X20901930-fig1.jpg

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