小儿急性白血病长期存活的因素探讨

STUDY OF FACTORS AFFECTING LONG-TERM SURVIVAL IN CHILDREN WITH ACUTE LEUKEMIA

本文报告存活3年以上的小儿急性白血病30例,男22例,女8例,年龄2～13岁。其中13例存活≥5年,6例已无病存活10年以上。结果表明,高危急性淋巴细胞白血病初治时,外周血白细胞数≥25×10~9/L,中枢神经系统白血病和骨髓复发是影响长期生存的危险因素。提示化疗过程中保持骨髓轻度抑制,加强前2年的化疗强度,坚持5年维持治疗及加强髓外白血病的防治是取得长期存活的关键。

This paper reports the results of our study of 30 children with acute leukemia who survived over 3 years. Thirteen of them survived over 5 years and six over 6 years, without any disease. Our study reveals that the factors affecting a long-term survival without disease include ① a white blood cell count over 25×10~9/L in the peripheral blood at the time of initial treatment, in cases of high-risk leukemia (ALL); ② leukemia in the central nervous system; and ③ a relapse in the marrow, which is easily induced by leukemia in the testis. The keys to a long-term survival are ① a sustained slight inhi- bition of the marrow in the period of treatment; ② intensified treatment in the initial two years; ③ maintenance treatment continued for no less than 5 years; and ④ intensi- fied prophylaxis against extramdeular leukemia.