中国当代儿科杂志2008，Vol.10Issue(1)：1-4,4.
ALL-XH-99方案治疗儿童急性淋巴细胞性白血病疗效分析
Therapeutic effectiveness of the ALL-XH-99 protocol for childhood acute lymphoblastic leukemia
王艳荣 1金润铭 1徐佳伟 1肖燕 1周东风 1张志泉1
作者信息
- 1. 华中科技大学同济医学院附属协和医院儿科,湖北武汉,430022
- 折叠
摘要
Abstract
Objective The ALL-XH-99 protocol for the treatment of childhood acute lymphoblastic leukemia (ALL) has been performed in the Union Hospital for 10 years. This study aimed to evaluate the therapeutic effectiveness of theprotocol for childhood ALL and to investigate the prognostic factors for childhood ALL. Methods This is a retrospective study. The eligible patients were treated with the ALL-XH-99 protocol. However a minor modification based on the ALL-XH-99 protocol was performed in this study, i. e. , the high-risk patients as the low- and moderate-risk patients were not administered with cranial irradiation. Event-free survival (EFS) was evaluated using the Kaplan-Meier method and thedifferences of the EFS among groups were compared with the log-rank test. Prognostic factors for childhood ALL were investigated by the stepwise Cox proportional hazard model. Results One hundred fifteen patients were eligible for theALL-XH-99 protocol chnical study. The 115 patients consisted of 62 low-risk, 12 moderato-risk and 41 high-risk patients. The overall EFS at 5 years in the 115 patients was 69.0±5.0%. The 5-year-EFS in the low-risk, moderate-risk and high-risk patients was 82.0±6.0%, 77.0±15.0% and 43.0±11.0%, respectively (P<0.01). Relapse occurred in 16patients (13.9%) in a median time of 17 months. Without administering cranial irradiation to all of the patients, the incidence of CNS leukemia relapse (2/115, 1.7% ) was not higher than that previously reported. Multivariate analysisshowed that the risk degree of leukemia, the presence of t(9;22)/bcr/abl fusion gene and leukocyte count were independent adverse prognostic factors for ALL and their hazard ratio was 1. 867, 3. 397 and 2. 236 respectively.Conclusions The therapeutic effectiveness of the ALL-XH-99 protocol for childhood ALL is satisfactory, with an EFS rate comparable to that of the developed countries, t(9;22)/bcr/abl is the most important adverse independent prognosticfactor for childhood ALL. Cranial irradiation may be eliminated to reduce late adverse effects in all of ALL patients.关键词
急性淋巴细胞性白血病/预后因素/无事件生存/儿童Key words
Acute lymphoblastic leukemia/ Prognostic factor/ Event-free survival/ Child分类
医药卫生引用本文复制引用
王艳荣,金润铭,徐佳伟,肖燕,周东风,张志泉..ALL-XH-99方案治疗儿童急性淋巴细胞性白血病疗效分析[J].中国当代儿科杂志,2008,10(1):1-4,4.
