中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2013年
6期
467-471
,共5页
梅妍妍%高超%崔蕾%赵晓曦%赵玮%李伟京%王凯玲%姜锦%张瑞东
梅妍妍%高超%崔蕾%趙曉晞%趙瑋%李偉京%王凱玲%薑錦%張瑞東
매연연%고초%최뢰%조효희%조위%리위경%왕개령%강금%장서동
白血病,淋巴样%儿童%临床方案%疗效比较研究%E2A-PBX1
白血病,淋巴樣%兒童%臨床方案%療效比較研究%E2A-PBX1
백혈병,림파양%인동%림상방안%료효비교연구%E2A-PBX1
Leukemia,lymphoid%Child%Clinical protocols%Comparative effectiveness research%E2A-PBX1
目的 比较E2A-PBXl+儿童急性淋巴细胞白血病(ALL)经北京儿童医院2003方案(BCH-03组)及中国儿童白血病协作组2008方案组(CCLG-08组)治疗的效果.方法 回顾性分析2003年1月至2011年1月初治的59例E2A-PBXl+患儿的临床资料,其中BCH-03组37例,CCLG-08组22例.分析两组患儿的初诊临床特征、早期治疗反应、复发时间、无复发生存(RFS)、无事件生存(EFS)等.结果 两组患儿在性别、年龄、初诊外周血白细胞计数、中枢神经系统累及、免疫表型、早期泼尼松治疗反应及诱导缓解率等方面差异均无统计学意义(P值均＞0.05).在诱导缓解治疗阶段,BCH-03组采用60 mg/m2泼尼松,CCLG-08组采用6 mg/m2地塞米松,其他药物的剂量及治疗方式均一致.在诱导缓解治疗结束时,BCH-03组患儿的微小残留病转阴的比例显著高于CCLG-08组(84.2％ vs.47.1％,P=0.018).两组诱导缓解治疗期间感染发生率差异无统计学意义(P=0.135).BCH-03组的EFS显著优于CCLG-08组(94.5％ vs.71.5％,P=0.010),RFS可能优于CCLG-08组(94.5％ vs.78.6％,P=0.059).结论 BCH-03方案比CCLG-08方案对E2A-PBXl+儿童ALL可能具有更好的治疗效果,60 mg/m2泼尼松可能更适合此亚型白血病的诱导缓解治疗.
目的 比較E2A-PBXl+兒童急性淋巴細胞白血病(ALL)經北京兒童醫院2003方案(BCH-03組)及中國兒童白血病協作組2008方案組(CCLG-08組)治療的效果.方法 迴顧性分析2003年1月至2011年1月初治的59例E2A-PBXl+患兒的臨床資料,其中BCH-03組37例,CCLG-08組22例.分析兩組患兒的初診臨床特徵、早期治療反應、複髮時間、無複髮生存(RFS)、無事件生存(EFS)等.結果 兩組患兒在性彆、年齡、初診外週血白細胞計數、中樞神經繫統纍及、免疫錶型、早期潑尼鬆治療反應及誘導緩解率等方麵差異均無統計學意義(P值均＞0.05).在誘導緩解治療階段,BCH-03組採用60 mg/m2潑尼鬆,CCLG-08組採用6 mg/m2地塞米鬆,其他藥物的劑量及治療方式均一緻.在誘導緩解治療結束時,BCH-03組患兒的微小殘留病轉陰的比例顯著高于CCLG-08組(84.2％ vs.47.1％,P=0.018).兩組誘導緩解治療期間感染髮生率差異無統計學意義(P=0.135).BCH-03組的EFS顯著優于CCLG-08組(94.5％ vs.71.5％,P=0.010),RFS可能優于CCLG-08組(94.5％ vs.78.6％,P=0.059).結論 BCH-03方案比CCLG-08方案對E2A-PBXl+兒童ALL可能具有更好的治療效果,60 mg/m2潑尼鬆可能更適閤此亞型白血病的誘導緩解治療.
목적 비교E2A-PBXl+인동급성림파세포백혈병(ALL)경북경인동의원2003방안(BCH-03조)급중국인동백혈병협작조2008방안조(CCLG-08조)치료적효과.방법 회고성분석2003년1월지2011년1월초치적59례E2A-PBXl+환인적림상자료,기중BCH-03조37례,CCLG-08조22례.분석량조환인적초진림상특정、조기치료반응、복발시간、무복발생존(RFS)、무사건생존(EFS)등.결과 량조환인재성별、년령、초진외주혈백세포계수、중추신경계통루급、면역표형、조기발니송치료반응급유도완해솔등방면차이균무통계학의의(P치균＞0.05).재유도완해치료계단,BCH-03조채용60 mg/m2발니송,CCLG-08조채용6 mg/m2지새미송,기타약물적제량급치료방식균일치.재유도완해치료결속시,BCH-03조환인적미소잔류병전음적비례현저고우CCLG-08조(84.2％ vs.47.1％,P=0.018).량조유도완해치료기간감염발생솔차이무통계학의의(P=0.135).BCH-03조적EFS현저우우CCLG-08조(94.5％ vs.71.5％,P=0.010),RFS가능우우CCLG-08조(94.5％ vs.78.6％,P=0.059).결론 BCH-03방안비CCLG-08방안대E2A-PBXl+인동ALL가능구유경호적치료효과,60 mg/m2발니송가능경괄합차아형백혈병적유도완해치료.
Objective To evaluate the efficacy of BCH-03 and CCLG-08 protocols in treating E2APBX1 pediatric acute lymphoblastic leukemia (ALL).Method From January 2003 to January 2011,59 ALL patients identified as E2A-PBX1 were analyzed in a retrospective study.There were 37 and 22 patients treated with Protocol BCH-03 and CCLG-08,respectively.The clinical characteristics at diagnosis,response to early treatment,the time of relapse,relapse-free survival (RFS) and event-free survival (EFS) in the two groups were analyzed.Result There were no significant differences in gender,age,initial white blood cell count,the central nervous system involvement,immunophenotype,prednisone response,the rate of complete remission,and the time of relapse between the two groups (P ＞ 0.05).The only difference in induction therapy of the two protocols existed in the glucocorticoids used,that is,BCH-03 used 60 mg/m2 prednisolone and CCLG-08 used 6 mg/m2 dexamethasone.The doses of vincristine,daunorubicin and Lasparaginase were the same in the two groups.At the end of induction therapy,the MRD negativity rate in BCH-03 group was significantly higher than that in CCLG-08 group (84.2％ vs.47.1％,P =0.018).The incidences of severe infection of the two groups during induction of remission were similar (P =0.135).The EFS of BCH-03 group was significantly superior to that of CCLG-08 group (94.5％ vs.71.5％,P =0.010),and the RFS of BCH-03 group tended to be better than that of CCLG-08 group (94.5％ vs.78.6％,P =0.059).Conclusion Compared to Protocol CCLG-08,Protocol BCH-03 was more effective for pediatric E2A-PBX1 ALL,and 60 mg/m2 prednisolone was more suitable for the induction therapy of this subtype of pediatric ALL.
