Department of Pediatrics, Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti - Hemorio, Rio de Janeiro, Brazil.
Clinical Medicine Post-Graduation Program, College of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Cancer Rep (Hoboken). 2022 Jan;5(1):e1452. doi: 10.1002/cnr2.1452. Epub 2021 Jun 11.
Acute lymphoblastic leukemia (ALL) is the most common neoplasm in childhood. The probability of current overall survival (OS) is around 90% in developed countries. There are few studies that demonstrate the results in Brazil.
This work aims to analyze the results of children with ALL treated at a single institution in Rio de Janeiro.
Retrospective analysis survival study of a cohort of childhood ALL patients treated in Hemorio. Kaplan-Meier and log-rank methods were used for the analysis of OS and events-free survival (EFS) and the Cox proportional hazards regression model for multivariate analysis. The probability of OS and EFS at 6 years was 52% and 45%. The probability of OS and EFS in 6 years for patients aged 10-17 years was 31% and 28% and for the younger was 65% and 55%, respectively (p < .001). A probability of OS and EFS in 6 years for patients with more than 100 000 leukocytes/mm at diagnosis was 19% and 16% and those with less than 100 000 were 62% (p = .007) and 55% (p = .008). Those who received less than 10 doses of native Escherichia coli asparaginase had a probability of OS and EFS in 6 years of 27% and 21% and those who received at least 10 doses were 74% and 65% (p < .001).
The presence of a high number of adolescents and high-risk patients, as well as many patients who discontinued the use of asparaginase or any substitute led to a lower probability of OS and EFS in our cohort.
急性淋巴细胞白血病（ALL）是儿童中最常见的肿瘤。在发达国家，目前的总生存率（OS）约为 90%。在巴西，很少有研究能够证明这一结果。
本研究旨在分析在里约热内卢的一家机构接受治疗的 ALL 患儿的结果。
回顾性分析了 Hemorio 治疗的儿童 ALL 患者队列的生存研究。使用 Kaplan-Meier 和对数秩方法分析 OS 和无事件生存（EFS），并使用 Cox 比例风险回归模型进行多变量分析。6 年 OS 和 EFS 的概率分别为 52%和 45%。10-17 岁患者的 6 年 OS 和 EFS 概率分别为 31%和 28%，而年龄较小的患者为 65%和 55%（p<0.001）。诊断时白细胞计数超过 10 万/mm3 的患者 6 年 OS 和 EFS 概率分别为 19%和 16%，白细胞计数低于 10 万/mm3 的患者为 62%（p=0.007）和 55%（p=0.008）。接受少于 10 剂天然大肠杆菌 asparaginase 的患者 6 年 OS 和 EFS 概率分别为 27%和 21%，而接受至少 10 剂 asparaginase 的患者为 74%和 65%（p<0.001）。
高比例的青少年和高危患者以及许多停止使用 asparaginase 或任何替代品的患者导致我们的队列 OS 和 EFS 的概率较低。
