采用同济95-1方案治疗小儿血液肿瘤9例疗效分析

Analysis of the outcome of childhood hematological malignancies treated with TJ95-1 protocol for nine cases

目的探索在基层医院采用先进的诊疗技术治疗儿童血液肿瘤的可能性和远期疗效。方法采用文献报道的同济95-1(TJ95-1)方案治疗儿童急淋白血病(ALL)和晚期非霍奇金淋巴瘤(NHL),统计远期疗效。并积极防治强烈化疗后并发症,提高医疗安全。结果近4年中分别治疗6例ALL和3例Ⅳ期NHL,平均随访时间25个月。9例病儿经过诱导治疗后均获得完全缓解(CR),目前3例已经完成3.5年的计划总疗程,停药随访中;其余6例仍CR中,其中1例CR已3年,2例CR超过2年,无1例复发。采用积极的化疗并发症防治措施,病儿均能够度过骨髓抑制期,未出现重要脏器明显损伤和化疗相关死亡。结论初步结果显示,在基层单位采用先进治疗方案,以及积极的化疗并发症防治措施,还是完全能够开展儿童血液肿瘤的现代治疗,并获得较佳的远期疗效。

Objective To explore the possibility and long-term effects of childhood hematological malignancies treated with advanced protocols in a county hospital. Methods To calculate the long-term effects of childhood acute lymphoblastic leukemia （ALL） and advanced non-Hodgkin＇ s lymphoma （NHL） treated by reported TJ95-1 protocol with comprehensive procedures to protect and treat the complications related intensive chemotherapy. Results In the recent about four years, 5 of cases with ALL and 4 of stage Ⅳ NHL were treated. The patients were followed up for average twenty-five months. The 9 cases were all achieved complete remission （CR） after induction therapy, and up to now, they were still in the state of CR. There were 3 cases has finished the all course of TJ95-1 in 3.5 years and stopped the therapy. The other 6 of cases were still in the chemotherapy, in which one case and two cases had been CR for more than three and two years respectively. By using the comprehensive procedures to protect and treat the complications related intensive chemotherapy, all patients recovered in the bone marrow suppression after intensive chemotherapy and there were non evident significant side-effects could be found and no chemotherapy related death appeared. Conclusion The study results showed that it is well possible to use advanced protocol and effective methods for side-effect prophylaxis to treat childhood hematological malignancies and achieve good outcome in a county hospital.