Chen Xia, Lei Xiao-Ying, Guan Xian-Min, Dou Ying, Wen Xian-Hao, Guo Yu-Xia, Gao Hui-Qin, Yu Jie
Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2024 Jul 15;26(7):701-707. doi: 10.7499/j.issn.1008-8830.2401010.
To investigate the cumulative incidence of recurrence (CIR) in children with acute lymphoblastic leukemia (ALL) after treatment with the Chinese Children's Cancer Group ALL-2015 (CCCG-ALL-2015) protocol and the risk factors for recurrence.
A retrospective analysis was conducted on the clinical data of 852 children who were treated with the CCCG-ALL-2015 protocol from January 2015 to December 2019. CIR was calculated, and the risk factors for the recurrence of B-lineage acute lymphoblastic leukemia (B-ALL) were analyzed.
Among the 852 children with ALL, 146 (17.1%) experienced recurrence, with an 8-year CIR of 19.8%±1.6%. There was no significant difference in 8-year CIR between the B-ALL group and the acute T lymphocyte leukemia group (>0.05). For the 146 children with recurrence, recurrence was mainly observed in the very early stage (=62, 42.5%) and the early stage (=46, 31.5%), and there were 42 children with bone marrow recurrence alone (28.8%) in the very early stage and 27 children with bone marrow recurrence alone (18.5%) in the early stage. The Cox proportional-hazards regression model analysis showed that positive fusion gene (=4.177, 95%: 2.086-8.364, <0.001) and minimal residual disease≥0.01% on day 46 (=2.013, 95%: 1.163-3.483, =0.012) were independent risk factors for recurrence in children with B-ALL after treatment with the CCCG-ALL-2015 protocol.
There is still a relatively high recurrence rate in children with ALL after treatment with the CCCG-ALL-2015 protocol, mainly bone marrow recurrence alone in the very early stage and the early stage, and minimal residual disease≥0.01% on day 46 and positive fusion gene are closely associated with the recurrence of B-ALL.
探讨采用中国儿童癌症协作组ALL-2015（CCCG-ALL-2015）方案治疗的急性淋巴细胞白血病（ALL）患儿的复发累积发生率（CIR）及复发危险因素。
对2015年1月至2019年12月采用CCCG-ALL-2015方案治疗的852例患儿的临床资料进行回顾性分析。计算CIR，并分析B系急性淋巴细胞白血病（B-ALL）复发的危险因素。
在852例ALL患儿中，146例（17.1%）复发，8年CIR为19.8%±1.6%。B-ALL组与急性T淋巴细胞白血病组的8年CIR差异无统计学意义（>0.05）。146例复发患儿中，复发主要发生在极早期（=62例，42.5%）和早期（=46例，31.5%），极早期有42例单纯骨髓复发（28.8%），早期有27例单纯骨髓复发（18.5%）。Cox比例风险回归模型分析显示，融合基因阳性（=4.177，95%：2.086 - 8.364，<0.001）和第46天微小残留病≥0.01%（=2.013，95%：1.163 - 3.483，=0.012）是CCCG-ALL-2015方案治疗后B-ALL患儿复发的独立危险因素。
CCCG-ALL-2015方案治疗后的ALL患儿仍有较高的复发率，主要为极早期和早期单纯骨髓复发，第46天微小残留病≥0.01%和融合基因阳性与B-ALL复发密切相关。
