CCLG-2008方案治疗儿童急性T淋巴细胞白血病单中心疗效分析

Efficacy of CCLG-2008 protocol in treating childhood acute T lymphoblastic leukemia-a single center experience

目的分析CCLG-ALL2008方案治疗儿童急性T淋巴细胞白血病(T-ALL)的单中心临床疗效。方法收集我科接受CCLG-ALL2008方案治疗的25例T-ALL患儿的临床资料,回顾性分析病人治疗效果及治疗相关毒副作用。结果 25例患儿,中危7例,高危18例;伴有中枢神经系统白血病(CNSL)3例;诱导缓解率96%。化疗期间发生严重感染7例(28%),并发可逆性后部脑病综合征(PRES)3例,继发第二肿瘤朗格罕斯细胞组织细胞增生症(LCH)1例,发生治疗相关死亡(TRM)1例。3年累积复发率为(17±0.08)%。CNSL 3年累积复发率为(4±0.04)%。单纯髓外白血病(EML)3年累积复发率为(10±0.07)%。本组病人的3年总体生存率(OS)为(87±0.07)%,3年无事件生存率(EFS)为(83±0.08)%。影响生存的主要因素是疾病复发和诱导期严重感染所致TRM。结论 CCLG-ALL2008方案治疗儿童T-ALL的单中心初步疗效好,CR率高,复发率低。

Objective Analyzing the efficacy of the CCLG-ALL 2008 protocol in treating childhood Acute T lymphoblastic leukemia in a single center. Methods Collecting the biological characteristics of the disease and clinical data from 25 pediatric patients with T-ALL who were treated with the CCLG-ALL 2008 protocol in our department, and analyzing retrospectively the treatment outcomes and reatment-related toxicities. Results Of the 25 patients,7 were assessed to be at moderate risk, and 18 at high risk. Thine patients were accompanied by central nervous system leukemia （CNSL）. The overall complete t^mission （CR） rate was 96% at the end of the induction therapy. Seven （28%） patients developed severe infection during chemotherapy;3 developed posterior reversible encephalopathy syndrome （PRES） ;1 developed Langerhans cell histiocytosis （LCH） as secondary malignant tumor; and 1 experienced treatment-related mortality （TRM）. The 3-year cumulative relapse rate was （17 ±0.08 ）%. The 3-year cumulative relapse rate of CNSL was （4 ± 0.04） %. The 3-year cumulative relapse rate of isolated extramedullary leukemia （EML） was （10 ± 0.07 ）%. The 3-year overall survival （OS） rate was （87 ± 0.07）%. The 3-year event-free survival （EFS） rate was （83 ±0.08）%. The main factorsaffecting survival were disease relapse and TRM caused by severe infection during induction therapy. Conclusions The CCLG-ALL 2008 protocol has produced favorable preliminare- efficacy for the treatment of childhood T-ALL in our single center,with high CR rate and low relapse rate.