GGLG-08方案联合伊马替尼治疗儿童Ph阳性急性淋巴细胞白血病的疗效与安全性分析

Efficacy and Safety of GGLG-08 Program Combined with Imatinib for Ph-positive Acute Lymphoblastic Leukemia in Children

目的研究GGLG-08方案联合伊马替尼治疗儿童Ph阳性急性淋巴细胞白血病的效果与安全性。方法回顾性分析51例儿童Ph^+急性淋巴细胞白血病患儿的临床资料,给予对照组患儿CCLG-ALL2008化疗方案,治疗组患儿采用伊马替尼联合CCLG-ALL2008化疗方案,比较2组患儿的治疗疗效及不良反应,同时分析影响患儿诱导缓解后5年生存率的主要因素。结果对照组患儿诱导治疗后完全缓解(CR)率为92.86%,治疗组患儿CR率为95.65%;治疗组患儿1年无事件生存率(EFS)为91.30%,3年无事件生存率(EFS)为69.57%,5年无事件生存率(EFS)为65.22%。与对照组比较,治疗组未增加化疗相关毒性。导致患儿诱导缓解后5年生存率降低的独立风险因素为:患儿对糖皮质激素诱导不敏感、治疗依从性差、治疗中复发以及首次诱导缓解失败。结论 GGLG-08方案与伊马替尼联合使用治疗儿童Ph阳性急性淋巴细胞白血病的临床疗效明显,安全性良好。

Objective To study the efficacy and safety of GGLG-08 program combined with imatinib for Ph-positive a- cute lymphoblastic leukemia in children. Methods A retrospective analysis of clinical data of 51 cases of Ph ~ acute lymphoblas- tic leukemia in children were conducted, the control group received CCLG-ALL2008 chemotherapy, the treatment group received imatinib joint CCLG-ALL2008 chemotherapy, the efficacy and adverse reactions of the 2 groups were compared, and the main fac- tors for 5-year survival rate in children after induction of remission were analyzed. Results Complete remission （CR） rate of the control group after induction therapy was 92.86%, and CR of the treatment group was 95.65% ; 1 -year event-free survival （EFS） of the treatment group was 91.30% ,3-year EFS was 69.57% ,and 5-year EFS was 65.22% ;compared with the control group,the treatment group did not increase chemotherapy-related toxicity. Independent risk factors lead to low 5-year survival rate after in- duction of remission were children of glueocorticoid-induced insensitive, poor compliance with treatment, relapse and remission in- duction failure for the first time. Conclusion GGLG-08 program combined with imatinib therapy for Ph-positive acute lympho- blastic leukemia is effective,with good security.