采用改良柏林-法兰克福-明斯特（BFM）方案治疗儿童急性淋巴细胞白血病的长期结局：来自一个发展中国家的多中心分析
Long-Term Outcomes of Childhood Acute Lymphocytic Leukemia Treated with Adapted Berlin-Frankfurt-Münster (BFM) Protocols: A Multicentric Analysis from a Developing Country.
作者信息
Horn Patricia Regina Cavalcanti Barbosa, Ribeiro-Carvalho Marilza de Moura, Azevedo Alice Maria Boulhosa de, Sousa Adriana Martins de, Faria Simone, Wiggers Cristina, Rouxinol Soraia, Schramm Marcia Trindade, Sanches Bárbara Sarni, Duarte Nathalia Lopez, Seixas Teresa de Souza Fernandez, Gomes Bernadete Evangelho, Oliveira Elen de, Arcuri Leonardo Javier, Costa Elaine Sobral da, Land Marcelo Gerardin Poirot, Souza Maria Helena Faria Ornellas de
机构信息
Department of Hematology, Universidade Estadual do Rio de Janeiro, Rio de Janeiro 20559-900, Brazil.
Bone Marrow Transplantation Unit, Instituto Nacional de Cancer, Rio de Janeiro 20230-130, Brazil.
出版信息
Cancers (Basel). 2024 Aug 21;16(16):2898. doi: 10.3390/cancers16162898.
INTRODUCTION
The objective of the current study was to determine the survival probabilities of children and adolescents with acute lymphocytic leukemia treated with adapted Berlin-Frankfurt-Münster (BFM) protocols and compare our results with the original BFM reports.
METHODS
This retrospective study included 695 patients up to 19 years old treated with adapted BFM protocols between 1997 and 2018 in four hospitals in Rio de Janeiro. The 1997-2007 and 2008-2018 cohorts were analyzed separately.
RESULTS
More than half of the patients were stratified into the high-risk BFM classification. Overall and event-free survivals were, in the 1997-2007 period, respectively, 88% and 80% (BFM standard risk group-SRG), 75% and 67% (intermediate risk group-IRG), and 48% and 33% (high-risk group-HRG). The corresponding numbers for the 2008-2018 period were 93% and 84% (SRG), 75% and 63% (IRG), and 64% and 57% (HRG). In the second period, both the OS (HR = 0.71, = 0.011) and EFS (HR = 0.62, < 0.001) were higher. Except for the intermediate-risk group, the latter results are comparable to the BFM.
CONCLUSION
The BFM protocol adaptations can be safely implemented in developing countries, accounting for local specificities.
引言
本研究的目的是确定采用改良柏林-法兰克福-明斯特（BFM）方案治疗的儿童和青少年急性淋巴细胞白血病患者的生存概率，并将我们的结果与原始BFM报告进行比较。
方法
这项回顾性研究纳入了1997年至2018年期间在里约热内卢的四家医院接受改良BFM方案治疗的695名19岁以下患者。分别对1997 - 2007年和2008 - 2018年队列进行分析。
结果
超过一半的患者被分层为高风险BFM分类。在1997 - 2007年期间，总体生存率和无事件生存率分别为88%和80%（BFM标准风险组 - SRG）、75%和67%（中风险组 - IRG）以及48%和33%（高风险组 - HRG）。2008 - 2018年期间的相应数字分别为93%和84%（SRG）、75%和63%（IRG）以及64%和57%（HRG）。在第二个时期，总生存率（HR = 0.71，P = 0.011）和无事件生存率（HR = 0.62，P < 0.001）均更高。除中风险组外，后一结果与BFM相当。
结论
BFM方案的改良可以在发展中国家安全实施，同时考虑当地的特殊性。
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