Yildirim Ulku Miray, Tekkesin Funda, Koc Begum Sirin, Aydogdu Selime, Asarcikli Fikret, Kilic Suar Caki
Department of Pediatric Hematology-Oncology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkiye.
North Clin Istanb. 2023 Aug 10;10(4):458-469. doi: 10.14744/nci.2022.47600. eCollection 2023.
In childhood acute lymphoblastic leukemia (ALL), very promising results were obtained thanks to the developments in treatment strategies in recent years. However, acute complications during treatment continue to be the important causes of mortality and morbidity. In this study, acute complications that develop during the treatment of ALL in childhood were evaluated.
Medical records of 47 patients treated according to (ALL Intercontinental Berlin-Frankfurt-Münster) 2009 protocol between 2016 and 2021 were evaluated retrospectively.
Of 47 patients, 28 (59.6%) were male and 19 (40.4%) were female. The mean age at diagnosis was 5.9±4.2 years. Forty-four patients (93.6%) were pre-B cell ALL, 3 patients (6.4%) were pre-T cell ALL. Of 47 patients, 9 (19.1%) were high risk, 32 (68.1%) were intermediate risk, and 6 (12.8%) were standard risk. Acute complications developed in 38 patients (80.8%). Among these complications, infectious complications are the most common and these were followed by gastrointestinal complications, drug-related reactions, thrombotic, neurological, and endocrine/metabolic complications, respectively.
In terms of complications that may develop, the threshold of suspicion should be kept low, and patients should be treated with the same medical team in fully equipped centers with a multidisciplinary approach. Inpatient treatment strategies should be applied especially in the early stages of treatment. The importance of inpatient treatment strategy, especially in the early stages of treatment, is emphasized.
在儿童急性淋巴细胞白血病(ALL)中,由于近年来治疗策略的发展取得了非常有前景的结果。然而,治疗期间的急性并发症仍然是死亡率和发病率的重要原因。在本研究中,对儿童ALL治疗期间发生的急性并发症进行了评估。
回顾性评估了2016年至2021年间根据(ALL洲际柏林-法兰克福-明斯特)2009方案治疗的47例患者的病历。
47例患者中,男性28例(59.6%),女性19例(40.4%)。诊断时的平均年龄为5.9±4.2岁。44例患者(93.6%)为前B细胞ALL,3例患者(6.4%)为前T细胞ALL。47例患者中,9例(19.1%)为高危,32例(68.1%)为中危,6例(12.8%)为标危。38例患者(80.8%)发生了急性并发症。在这些并发症中,感染性并发症最为常见,其次分别是胃肠道并发症、药物相关反应、血栓形成、神经和内分泌/代谢并发症。
就可能发生的并发症而言,应保持较低的怀疑阈值,患者应在配备齐全的中心由同一医疗团队采用多学科方法进行治疗。住院治疗策略应尤其在治疗早期应用。强调了住院治疗策略在治疗早期尤其是早期阶段的重要性。