ALL-2005方案治疗婴幼儿急性淋巴细胞白血病疗效及研究

Effectiveness of ALL-2005 protocol in the treatment of acute lymphoblastic leukemia in infants

目的探讨急性淋巴细胞白血病(ALL)-2005方案治疗婴幼儿ALL的临床疗效及预后。方法回顾性研究自2005年5月至2009年4月,在上海交通大学医学院附属上海儿童医学中心经形态学、免疫学、遗传学,分子生物学(MICM)检查明确诊断,通过ALL-2005方案治疗的88例婴幼儿(<3岁)ALL的疗效。结果本院所有回顾性研究数据自2005年起通过儿童肿瘤网络数据库(POND)统计,在4年随访期间,共有88例婴幼儿ALL患儿在本院接受治疗。男61例(69.32%),女27例(30.68%),中位年龄2.08岁(0～2.92岁)。84例(95.45%)为B细胞标记,4例(4.54%)为T细胞标记。低危36例(40.91%),中危50例(56.82%),高危2例(2.27%)。中位随访时间为33.0个月(1.0～68.2月),81例(92.05%)诱导治疗后获得完全缓解,在诱导治疗阶段完全缓解,17例(19.32%)复发。4年无事件生存率(EFS)及生存率分别为69.51%及82.95%。结论上海交通大学医学院附属上海儿童医学中心ALL-2005方案治疗婴幼儿ALL的4年无事件生存率已接近70%,取得较好的临床疗效。

Objective To evaluate the therapeutic effectiveness and prognostic factors of ALL in infants treated with ALL-2005 protoco1. Methods Eighty-eight patients with ALL under 3 years of age were retrospectively studied ,who were newly diagnosed by morphologic and immunologic genetics and molecular biology （MICM）, and were enrolled in the ALL-2005 treatment protocol from May 2005 to April 2009 in Shanghai Children’s Medical Center SCMC. Results Data were retrospectively collected since 2005 using the pediatric oncology networked database （POND）. And altogether 88 children under 3 years of age with ALL received treatment in SCMC in the following four years. Among the 88 cases of ALL, 61 （69.32%） were males and 27 （30.68%） were females. The median age at diagnosis was 2.08 years （0～2.92 years）. Eighy-four were B lineage-ALL and 4 were T lineage-ALL. Thirty-six （40.91%） children were classified as low-risk, 50 （56.82%） were standard-risk and 2 （2.27%） were high-risk. Eighty-one（92.05%） children completely remitted in induction while 17 （19.32%） children relapsed. After a median follow-up of 33 months （1.0～68.2 months）, the estimated 5-year event free survival （EFS）rate and overall survival rate were 69.51% and 82.95%, respectively. Conclusion The estimated 4-year EFS of ALL in infants has been close to 70%; the therapeutic effectiveness of the ALL-2005 protocol for ALL in infants is satisfactory.