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[不同治疗方案对急性淋巴细胞白血病或非霍奇金淋巴瘤患儿生长及最终身高的影响]

[Effect of various therapeutic protocols on growth and final height of children with acute lymphoblastic leukemia or non-Hodgkin's lymphoma].

作者信息

Timme J, Mittler U, Mohnike K, Dörffel W

机构信息

Klinik für Pädiatrische Hämatologie und Onkologie, Medizinischen Fakultät, Otto-von-Guericke-Universität Magdeburg.

出版信息

Klin Padiatr. 1995 Sep-Oct;207(5):267-70. doi: 10.1055/s-2008-1046549.

DOI:10.1055/s-2008-1046549
PMID:7500601
Abstract

A total of 74 children suffering from acute lymphoblastic leukaemia (ALL) or non-Hodgkin lymphoma (NHL) were involved in a retrospective analysis of their physical growth during and after the therapy. Out of this total number, 54 children were subjected to radiochemotherapy in compliance with the VII/(81) scheme, and another 20 children in compliance with the LSA2L2 scheme. At the beginning of the therapy the average height-standard deviation score (H-SDS) for both groups of patients corresponded with the population average. The patients subjected to the VII/(81) scheme showed, throughout the observation period of five years from the beginning of the therapy, a height normal for their age group. Contrary to this observation, the patients subjected to the LSA2L2 scheme experienced a significantly different growth in the period under observation and continually lost height in comparison to the normal population. The same results were experienced with a smaller group of patients whose growth was followed up for eight years from the beginning of therapy. 16 patients (VII/81 n = 4/LSA2L2 n = 12) reached their final height. For the patients of the VII/(81) scheme the final height showed an average H-SDS of 0.27 and for the patients of the LSA2L2 scheme of -1.22 (p = 0.068). Considering that the same cranial radiotherapy (max. 18 Gy for both schemes) and a comparable intensive induction therapy were applied, it must be concluded that the intensity and duration of the maintenance treatment are the critical factors initiating a different growth behaviour of the two groups subjected to radiochemotherapeutical schemes.

摘要

对74名患有急性淋巴细胞白血病(ALL)或非霍奇金淋巴瘤(NHL)的儿童进行了一项回顾性分析,以研究他们在治疗期间及治疗后的身体生长情况。在这74名儿童中,54名儿童按照VII/(81)方案接受了放化疗,另外20名儿童按照LSA2L2方案接受治疗。在治疗开始时,两组患者的平均身高标准差评分(H-SDS)与总体平均水平相符。接受VII/(81)方案治疗的患者在从治疗开始的五年观察期内,身高与其年龄组正常水平相符。与这一观察结果相反,接受LSA2L2方案治疗的患者在观察期内生长情况明显不同,与正常人群相比持续身高下降。对一小群从治疗开始随访八年的患者也得到了相同的结果。16名患者(VII/81组n = 4/LSA2L2组n = 12)达到了最终身高。VII/(81)方案组患者的最终身高平均H-SDS为0.27,LSA2L2方案组患者为-1.22(p = 0.068)。考虑到两种方案均采用了相同的颅脑放疗(最大剂量均为18 Gy)以及类似的强化诱导治疗,可以得出结论,维持治疗的强度和持续时间是引发接受两种放化疗方案的两组患者出现不同生长行为的关键因素。

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