儿童急性非淋巴细胞性白血病89例临床分析

Clinic Analysis of Childhood Acute Non-lymphocytic Leukemia

目的探讨儿童急性非淋巴细胞白血病(ANLL)的临床特征及对不同治疗的反应与预后的关系。方法对我院2003年1月～2007年9月89例儿童ANLL进行总结分析。结果①儿童ANLL以M1、M2亚型居多,占37.1%;临床表现中髓外浸润较多见;②总诱导缓解率68.6%,使用DAE诱导方案1疗程CR率为40.1%;③全反式维甲酸(ATRA)联合三氧化二砷(As2O3)治疗急性早幼粒细胞性白血病(APL)缓解率87.5%,平均CCR33个月;④进入巩固治疗的ANLL患儿中5例完成4次大剂量Ara-c强化治疗,其中3例CCR≥36个月。结论①儿童ANLL的1疗程CR率与诱导治疗的强度相关;②As2O3有助于降低APL患儿的复发率,提高长期无病生存率;③大剂量阿糖胞苷(HDAra-c)强化治疗有助于提高儿童ANLL的无病生存率。

Objective To explore the clinical characters and the relationship between prognosis and treatment in childhood acute non- lymphocytic leukemia（ANLL）. Method We summarized and analyzed the cases with acute non -lymphocytic leukemia in children patients from our hospital admission between Jan 2003 and Sep 2007. Results ①The M1 ,M2 subtype of childhood ANLL were about 37.1% ; the clinical situation was various; extramedullary infiltration was not uncommon;②A totle complete remission （CR） rate was 68.6% and the CR rate of one course chemotherapy was 40.1% ;③The CR rate of acute promyelocytic leukemia （APL） was 87.5% and a average of continues CR （CCR）was 33 months after the treatment of ATRA combined with As2O3 ; ④Among five patients finished all the courses of high dose Ara - c（ HDAra - c） intensification therapy,three were CCR over 36 months. Conclusion ①The CR rate of one course chemotherapy was correlated to the intensity of treatment;②The treatment of As2O3 can help to lower the relapse of APL and enhance the event - free survival（EFS） ; ③The treatment of HDAra - c can help to increase the EFS rate of childhood ANLL.