CCLG-ALL2008方案治疗儿童急性淋巴细胞白血病死亡病例分析

Analysis on Death Cases in Children with Acute Lymphoblastic Leukemia Treated with the CCLG-ALL 2008 Protocol

目的:回顾性分析应用CCLG-ALL2008方案治疗儿童急性淋巴细胞白血病(ALL)患者的死亡原因,总结经验,以期降低患儿死亡率。方法:2008年4月至2015年4月在本院诊断并接受CCLG-ALL2008方案治疗的儿童ALL患者共计916例,选取其中死亡的病例进行回顾性分析。结果:死亡患者共169例,男性111例(65.7%),女性58例(34.3%)。复发为主要的死亡原因,由复发导致死亡的患者有150例(88.7%),其中86例(57.3%)复发后家属直接放弃治疗。第二死亡原因为感染,感染部位主要集中在呼吸系统和消化系统,以细菌感染为主(多见于革兰氏阴性杆菌)。结论:加强经济支持、提高家属依从性可以降低儿童ALL的死亡率,早期合理地使用抗生素可以降低儿童ALL的感染相关死亡率。

Objective:To retrospective analyze the reason of death in children with acute lymphoblastic leukemia(ALL)treated with CCLG-ALL 2008 protocol,and the experience was summarized in order to reduce the mortality.Methods:916 children diagnosed as ALL and accepted CCLG-ALL 2008 protocol from April 2008 to April 2015 in our hospital were enrolled,the dead cases in them were analyzed retrospectively.Results:169 children died,including111(65.7%)males and 58(34.3%)females.Recurrence was the main reason of death.150(88.7%)children died due to recurrence,among them,86(57.3%)cases gave up directly.The second reason of death was infection.The main clinical sites of infection were concentrated in respiratory system and digestive system.Bacterial infection was most common(Gram-negative was common).Conclusion:Enough finance and improving family compliance can decrease the mortality in children with ALL.Early rational use of antibiotics can reduce infection-related mortality in children with ALL.