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[儿童急性T淋巴细胞白血病的预后因素:CCCG-ALL-2015方案的单中心临床研究]

[Prognostic factors in children with acute T-lymphoblastic leukemia: a single-center clinical study of the CCCG-ALL-2015 protocol].

作者信息

Fu Wen-Feng, Fang Yong-Jun

机构信息

Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2024 Oct 15;26(10):1078-1085. doi: 10.7499/j.issn.1008-8830.2402079.

Abstract

OBJECTIVES

To explore the clinical characteristics of children with acute T-lymphoblastic leukemia (T-ALL) and analyze their relationship with prognosis.

METHODS

A retrospective analysis was conducted on the clinical data and follow-up results of 50 children with T-ALL who were treated using the CCCG-ALL-2015 protocol at the Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University from November 2015 to December 2019. Kaplan-Meier survival analysis and Cox regression analysis were employed to identify factors affecting prognosis.

RESULTS

Among the 50 T-ALL patients, there were 7 cases of relapse. There was no statistically significant difference in the baseline clinical data between the relapse group and the non-relapse group (>0.05). However, the positive rate of minimal residual disease (MRD) (≥0.01%) on day 46 after induction remission therapy in the relapse group was significantly higher than that in the non-relapse group (=0.037). The 5-year overall survival rate for the 50 patients was (87±5)%, and the 5-year event-free survival rate was (86±5)%. Multivariate Cox regression analysis indicated that the MRD level on day 46 after induction remission therapy was an independent prognostic factor (=0.104, 95%: 0.015-0.740, =0.024).

CONCLUSIONS

MRD is of significant importance for the prognosis of T-ALL children. Personalized treatment should be provided based on MRD levels to prevent relapse and improve prognosis in these patients.

摘要

目的

探讨儿童急性T淋巴细胞白血病(T-ALL)的临床特征,并分析其与预后的关系。

方法

对2015年11月至2019年12月在南京医科大学附属儿童医院血液肿瘤科采用CCCG-ALL-2015方案治疗的50例T-ALL患儿的临床资料及随访结果进行回顾性分析。采用Kaplan-Meier生存分析和Cox回归分析确定影响预后的因素。

结果

50例T-ALL患者中,有7例复发。复发组与未复发组的基线临床资料差异无统计学意义(>0.05)。然而,诱导缓解治疗后第46天微小残留病(MRD)(≥0.01%)的阳性率在复发组显著高于未复发组(=0.037)。50例患者的5年总生存率为(87±5)%,5年无事件生存率为(86±5)%。多因素Cox回归分析表明,诱导缓解治疗后第46天的MRD水平是独立的预后因素(=0.104,95%:0.015-0.740,=0.024)。

结论

MRD对T-ALL患儿的预后具有重要意义。应根据MRD水平提供个性化治疗,以预防这些患者复发并改善预后。

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Acute lymphoblastic leukaemia.急性淋巴细胞白血病。
Lancet. 2020 Apr 4;395(10230):1146-1162. doi: 10.1016/S0140-6736(19)33018-1.

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