Mandelli F, Amadori S, Ceci A, Guazzelli C, Madon E, Marchi A, Masera G, Paolucci G, Zanesco L
Cancer. 1981 Dec 1;48(11):2364-7. doi: 10.1002/1097-0142(19811201)48:11<2364::aid-cncr2820481104>3.0.co;2-y.
Among 727 children with acute lymphocytic leukemia (ALL) observed at eight pediatric clinics in Italy in the years 1967-1974, 200 (27.5%) survived for more than five years after diagnosis. The proportion of long-term survivors rose significantly during the years 1970-1974 when aggressive therapeutic programs with curative intent were uniformly adopted in Italy (19.8% vs. 29.4%; P less than 0.05). Clinical and laboratory data at diagnosis of the 200 long-term survivors were analyzed and compared with that of the 527 nonsurvivors. We found that, besides a leukocyte count greater than 50,000 cells/mm3, other factors such as early central nervous system CNS leukemia and the presence of mediastinal mass were predictive of a poorer prognosis for long-term survival. Life-table analysis revealed that the chance of long-term survival was significantly higher in those children who have survived for five years without relapse (82.9% vs. 24.1%; P less than 0.01). Although late initial relapse is always possible, if a child with ALL remains in continuous complete remission for at least nine years, it is likely that the patient is cured.
1967年至1974年间，在意大利八家儿科诊所观察的727例急性淋巴细胞白血病（ALL）患儿中，200例（27.5%）在诊断后存活超过五年。在1970年至1974年间，当意大利统一采用具有治愈意图的积极治疗方案时，长期存活者的比例显著上升（19.8%对29.4%；P<0.05）。对200例长期存活者诊断时的临床和实验室数据进行了分析，并与527例非存活者的数据进行了比较。我们发现，除了白细胞计数大于50,000个细胞/mm³外，其他因素如早期中枢神经系统（CNS）白血病和纵隔肿块的存在预示着长期存活的预后较差。生命表分析显示，那些存活五年无复发的儿童长期存活的机会显著更高（82.9%对24.1%；P<0.01）。虽然晚期初始复发总是有可能的，但如果一名ALL患儿持续完全缓解至少九年，则该患者很可能已治愈。
