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小儿急性淋巴细胞白血病的治疗结果——罗马尼亚单中心经验

Outcomes in Pediatric Acute Lymphoblastic Leukemia-A Single-Center Romanian Experience.

作者信息

Alecsa Mirabela-Smaranda, Moscalu Mihaela, Trandafir Laura-Mihaela, Ivanov Anca-Viorica, Rusu Cristina, Miron Ingrith-Crenguta

机构信息

Department Mother and Child Care, Division of Neonatology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.

Department of Pediatric Hematology and Oncology, Sf. Maria Children's Emergency Hospital, 700309 Iasi, Romania.

出版信息

J Clin Med. 2020 Dec 15;9(12):4052. doi: 10.3390/jcm9124052.

Abstract

BACKGROUND

This study evaluates the main (para)clinical aspects and outcomes in a group of Romanian children diagnosed with acute lymphoblastic leukemia (ALL), under the conditions of antileukemic treatment according to an adapted ALL IC Berlin-Frankfurt-Munster (BFM) 2002 protocol.

METHODS

We performed a retrospective single-center study of 125 children diagnosed with ALL between 2010 and 2016. Standard forms were used for data collection of variate clinical and paraclinical parameters.

RESULTS

The children were predominantly male (64.8%) and their median age at diagnosis was 5 years. A total of 107 patients were diagnosed with precursor B-cell acute lymphoblastic leukemia (BCP)-ALL and 18 with T-cell acute lymphoblastic leukemia T-ALL. Multiplex reverse transcription polymerase chain reaction RT-PCR assay for ETV6-RUNX1, BCR-ABL, E2A-PBX1, KMT2A-AFF1, and STIL-TAL1 fusion genes was performed in 111 patients. ETV6-RUNX1 translocation was detected in 18.9% of patients, while BCR-ABL1 and E2A-PBX1 rearrangements were seen in 2.7% and 3.6%, respectively. Complete remission at the end of induction phase was obtained in 89.6% of patients. The overall relapse rate was 11.2%, with 11 early and 3 late relapses. The 5-year overall survival rate in BCP-ALL was 81.6% and in T-ALL 71.4%.

CONCLUSIONS

The 5-year overall and event-free survival rates in our study were slightly lower than those reported in developed countries, so the patients' outcomes are encouraging.

摘要

背景

本研究评估了一组根据改良的2002年急性淋巴细胞白血病(ALL)国际柏林-法兰克福-明斯特(BFM)方案接受抗白血病治疗的罗马尼亚儿童的主要(副)临床特征和治疗结果。

方法

我们对2010年至2016年间诊断为ALL的125名儿童进行了一项回顾性单中心研究。使用标准表格收集各种临床和副临床参数的数据。

结果

这些儿童以男性为主(64.8%),诊断时的中位年龄为5岁。共有107例患者被诊断为前体B细胞急性淋巴细胞白血病(BCP-ALL),18例为T细胞急性淋巴细胞白血病(T-ALL)。对111例患者进行了ETV6-RUNX1、BCR-ABL、E2A-PBX1、KMT2A-AFF1和STIL-TAL1融合基因的多重逆转录聚合酶链反应(RT-PCR)检测。18.9%的患者检测到ETV6-RUNX1易位,而BCR-ABL1和E2A-PBX1重排分别见于2.7%和3.6%的患者。89.6%的患者在诱导期结束时获得完全缓解。总复发率为11.2%,其中11例为早期复发,3例为晚期复发。BCP-ALL的5年总生存率为81.6%,T-ALL为71.4%。

结论

我们研究中的5年总生存率和无事件生存率略低于发达国家报道的水平,因此患者的治疗结果令人鼓舞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ab/7765371/bbb235befe7d/jcm-09-04052-g001.jpg

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