Creutzig U, Schaaff A, Ritter J, Jobke A, Kaufmann U, Schellong G
Klin Padiatr. 1984 May-Jun;196(3):130-4. doi: 10.1055/s-2007-1025595.
23 out of 151 patients of the childhood AML study BFM-78 were less than two years of age at the time of diagnosis, 10 of them being less than one year old. The incidence of M5-subtype was high in infants with 12/23 (52%) compared with 20/128 (16%) in those 2 to 17 years of age. The percentage of boys was 44% in the young children compared with 56% in the older ones. Initial skin infiltrations were seen in five infants with monoblastic subtypes (M4, M5) and in only three patients more than two years of age. The incidence of liver and spleen enlargement greater than or equal to 5 cm below the costal margin was significantly higher in young children. Due to infectious complications frequent therapy-free intervals and/or reduced drug dosages were necessary in the 8-week induction treatment regimen. The prophylactic cranial irradiation with 12 Gy in the first year of life and 15 Gy in the second year has so far not caused any long-term sequelae. The results were similar to those in older children: 18/23 (78%) of the infants achieved complete remission compared with 101/128 (79%) of those 2 to 17 years old. With a follow-up period of 16 to 49 months the probability of continuous complete remission (disease-free interval) was 52% in children under the age of 2 and 54% in those more than 2 years of age. We conclude that with the improved prognosis an intensive chemotherapy is justified in infants with acute myelogenous leukemia.
在儿童急性髓系白血病研究BFM - 78的151例患者中，23例在诊断时年龄小于2岁，其中10例小于1岁。婴儿中M5亚型的发生率较高，为12/23（52%），而2至17岁患者中为20/128（16%）。年幼儿童中男孩的比例为44%，年长儿童中为56%。5例单核细胞亚型（M4、M5）婴儿出现初始皮肤浸润，2岁以上患者仅3例有此情况。年幼儿童肝脾肿大至肋缘下5厘米及以上的发生率显著更高。由于感染并发症，在8周诱导治疗方案中需要频繁的无治疗间隔期和/或减少药物剂量。1岁时12 Gy、2岁时15 Gy的预防性颅脑照射迄今未引起任何长期后遗症。结果与年长儿童相似：23例婴儿中有18例（78%）达到完全缓解，2至17岁患者中有101例（79%）达到完全缓解。随访16至49个月，2岁以下儿童持续完全缓解（无病间期）的概率为52%，2岁以上儿童为54%。我们得出结论，随着预后改善，对急性髓性白血病婴儿进行强化化疗是合理的。
