ALL-BFM95方案治疗儿童急性淋巴细胞白血病的疗效及预后分析

Clinical Efficacy of ALL-BFM95 Therapy on Acute Lymphoblastic Leukemia in Children and Prognostic Analysis

目的探讨ALL-BFM95方案应用于急性淋巴细胞白血病(ALL)治疗中的临床效果并分析其预后因素,以提高ALL患儿无事件生存率(EFS)。方法回顾性分析2010年1月—2011年12月间收治的采用ALL-BFM95方案治疗的108例ALL患儿的临床资料,进行疗效评价和预后影响因素分析。结果 108例患儿中103例获完全缓解(CR),占比95.4%。总体5-year EFS为(63.1±5.8)%,平均生存时间(23.1±10.5)个月。诱导化疗6周未获CR5例,化疗相关死亡4例,中枢死亡7例,睾丸复发2例,骨髓复发22例,转为慢性粒细胞白血病2例。各因素分析显示,年龄组、性别组比较差异无统计学意义,免疫分型组、白细胞数组、危险度组、泼尼松诱导试验组相比差异显著。结论 ALL-BFM95方案治疗ALL患儿疗效确切,免疫分型、白细胞数、危险度、泼尼松诱导试验均为影响ALL患儿长期生存的预后独立因素。

Objective To investigate the clinical efficacy prognostic factors of ALL-BFM95 therapy on acute lymphoblastic leukemia（ ALL） in children to improve the event free survival（ EFS） of children with ALL. Methods The clinical data of 108 ALL children who were admitted and given ALL-BFM95 therapy in the hospital from January,2010 to December,2011 was reviewed and analyzed to evaluate the clinical efficacy and prognostic factors. Results 103 of the 108 children,accounting for 95. 4%,got complete remission（ CR）. The overall EFS for 5 years was（ 63. 1 ± 5. 8） % and the average survival time was（ 23. 1 ± 10. 5） months.After 6 weeks of induction chemotherapy,there were 5 cases failing to get CR,4 cases of death,7 cases of central death,2 cases of testis relapse,22 cases of bone marrow relapse,and 2 cases that became chronic myelocytic leukemia. According to the analysis on various factors,there was no statistical meaning in age or sex in two groups,but the difference was significant in groups formed based on immunophenotype,white cell count,risk degree,and prednisone induced test. Conclusion In treating ALL children,ALL-BFM95 therapy proves to be effective. Immunophenotype,white cell count,risk degree,and prednisone induced test are independent prognostic factors affecting the long-run survival of ALL children.