强烈化疗治疗儿童急性淋巴白血病的临床分析

Clinical analysis on intensive chemotherapy for treating children acute lymphoblastic leukemia

目的总结分析强烈化疗治疗小儿急性淋巴细胞白血病的临床疗效。方法121例患儿采用(VDLP)方案诱导缓解,缓解后用CAT、HDMTX、EA、VDLP方案早期巩固强化治疗,用MTX、6-MP维持治疗,用MA、EA、VDLP方案定期加强治疗,用HDMTX联合三联鞘注对庇护所白血病进行预防。结果完全缓解率(CR)95.8%,标危ALL为97.2%,高危ALL为92%。5a无事件生存(EFS)率为(70.2±6.2)%。标危ALL为(70.2±5.0)%,高危ALL为(55.3±8.9)%。结论采用多种非交叉耐药性抗肿瘤药物交替联合强烈化疗,庇护所预防治疗及完善的辅助治疗措施是减少白血病复发,提高EFS率的关键。

Objective] To analyze the clinical curative effect of intensive chemotherapy for treating children acute lymphoblastic leukemia. [Methods] 121 children patients with ALL were given induction therapy with VDLP regimen, initial intensive therapy with CAT, HDMTX, EA and VDLP regimen, then maintenance therapy with MTX and 6-MP. MA, EA and VDLP regimen were applied to carry out regular intensive treatment. HDMTX combined with three drug introducing chemotherapy was used prevent shelter leukemia. [Results] The complete remission rate was 95.8%, SR ALL was 97.2%, HR ALL was 92%, five year event free survival (EFS) rate was (70.2 ±6.2)%, SR ALL was (70.2±5.0)%, HR ALL was (55.3±8.9)%. [Conclusion] Intensive chemotherapy combined with non-cross drug-resistant antineoplastic during early treatment with the assistance of maintenance therapy is crucial in reducing the recurrence of leukemia and increasing EFS rate.