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儿童急性淋巴细胞白血病的复发:单中心经验

Relapses Children's Acute Lymphoblastic Leukemia, Single Center Experience.

作者信息

Stolpa Weronika, Zapała Magdalena, Zwiernik Bartosz, Mizia-Malarz Agnieszka

机构信息

Department of Oncology, Hematology and Chemotherapy, Upper Silesia Children's Care Heatlh Centre, 16 Medykow Street, 40-752 Katowice, Poland.

Student Scientific Club, Medical University of Silesia, 40-055 Katowice, Poland.

出版信息

Children (Basel). 2022 Nov 30;9(12):1874. doi: 10.3390/children9121874.

Abstract

The prognosis in children and adolescents with relapsed ALL, despite intensive therapy, including hematopoietic stem cell transplantation, is still challenging. This study aims to analyze the incidence of relapsed ALL and survival rates in correlation to the risk factors. Materials and methods: 125 pediatric patients with ALL diagnosed in our department between 2000-2018; age 1−18 years old (median 6.4); female 53.6% vs. male 46.4%. Results: 19 pts (15.2%) were diagnosed with a relapse. Three pts (15.8%) had been diagnosed with very early relapses (2/3 T-ALL), 12 pts (63.1%) as an early relapse, and 4 pts (21.1%) as a late relapse. Bone marrow was the most frequent relapses localization. The five-year survival has been achieved by six patients (31.6%). A significant difference was found in regard to the five-year overall survival and relapse type (p < 0.05). The group with very early relapses (3/3; 100%) has not reached the five-year survival. Conclusions: 1. The main prognostic factor in children’s ALL relapses is still the time of the onset of the relapse. 2. The T lineage acute lymphoblastic leukemia is a worse prognostic factor. 3. The analysis of the above relapse risk factors alongside cytogenethic markers and flow cytometry or polymerase chain reaction minimal residual disease is very important for first-line chemotherapy improvement and a more personalized choice of therapy for ALL patients.

摘要

尽管进行了包括造血干细胞移植在内的强化治疗,但复发的儿童和青少年急性淋巴细胞白血病(ALL)的预后仍然具有挑战性。本研究旨在分析复发ALL的发生率和生存率与危险因素的相关性。材料与方法:选取2000年至2018年间在我科诊断的125例ALL患儿;年龄1至18岁(中位年龄6.4岁);女性占53.6%,男性占46.4%。结果:19例(15.2%)被诊断为复发。3例(15.8%)被诊断为极早期复发(2/3为T-ALL),12例(63.1%)为早期复发,4例(21.1%)为晚期复发。骨髓是最常见的复发部位。6例患者(31.6%)实现了五年生存。在五年总生存率和复发类型方面发现了显著差异(p<0.05)。极早期复发组(3/3;100%)未达到五年生存。结论:1.儿童ALL复发的主要预后因素仍然是复发开始的时间。2.T系急性淋巴细胞白血病是一个预后较差的因素。3.结合细胞遗传学标志物、流式细胞术或聚合酶链反应微小残留病分析上述复发危险因素,对于改善一线化疗和为ALL患者选择更个性化的治疗非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/583e/9776902/dda808e3c857/children-09-01874-g001.jpg

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