CAJ | 학술논문

目的评估SCMC-ALL-2005方案治疗低危急性淋巴细胞白血病(ALL)患儿的远期疗效.方法 2005年5月1日至2009年4月30日采用SCMC-ALL-2005方案治疗ALL患儿共387例,根据细胞形态学、免疫学、细胞遗传学和分子生物学特点及治疗反应进行临床分组,纳入低危组的患儿共158例.对该组患儿进行临床特点、疗效及生存分析.结果随访至2012年12月31日,158例患儿5年无事件生存(EFS)率和总生存(OS)率分别为(77.76±3.37)％和(89.55±2.83)％.中位随访时间5.33(3.75～7.70)年.治疗相关死亡5例(3.16％),均为重症感染.27例(17.09％)复发,其中单纯骨髓复发13例(8.23％);单纯睾丸复发5例(占男性患儿5.32％),其中单侧2例,双侧3例;单纯中枢神经系统复发6例(3.80％);骨髓及中枢神经系统同时复发1例;骨髓及睾丸同时复发1例;另有1例复发于右侧卵巢.诱导缓解后微小残留病由阴性转为阳性与复发相关.2例(1.27％)患儿发生第二肿瘤.完全缓解期无特殊原因放弃治疗共4例(2.53％).结论 SCMC-ALL-2005方案治疗ALL低危患儿疗效较为理想,治疗相关死亡率较低,长期无病生存率较我院之前方案有所提高.
목적 평고SCMC-ALL-2005방안치료저위급성림파세포백혈병(ALL)환인적원기료효.방법 2005년5월1일지2009년4월30일채용SCMC-ALL-2005방안치료ALL환인공387례,근거세포형태학、면역학、세포유전학화분자생물학특점급치료반응진행림상분조,납입저위조적환인공158례.대해조환인진행림상특점、료효급생존분석.결과 수방지2012년12월31일,158례환인5년무사건생존(EFS)솔화총생존(OS)솔분별위(77.76±3.37)％화(89.55±2.83)％.중위수방시간5.33(3.75～7.70)년.치료상관사망5례(3.16％),균위중증감염.27례(17.09％)복발,기중단순골수복발13례(8.23％);단순고환복발5례(점남성환인5.32％),기중단측2례,쌍측3례;단순중추신경계통복발6례(3.80％);골수급중추신경계통동시복발1례;골수급고환동시복발1례;령유1례복발우우측란소.유도완해후미소잔류병유음성전위양성여복발상관.2례(1.27％)환인발생제이종류.완전완해기무특수원인방기치료공4례(2.53％).결론 SCMC-ALL-2005방안치료ALL저위환인료효교위이상,치료상관사망솔교저,장기무병생존솔교아원지전방안유소제고.
Objective To evaluate the long-term efficacy of SCMC-ALL-2005 protocol in treatment of low-risk childhood acute lymphoblastic leukemia (ALL).Methods From May 1,2005 to April 30,2009,387 patients enrolled into SCMC-ALL-2005 protocol.Based on the characteristics of cell morphology,immunology,cytogenetics and molecular biology and treatment response,158 patients were fit into the low-risk treatment group.All the cases were registered in pediatric oncology network database (POND).The clinical characteristics and outcome were analyzed.Results Until December 31,2012,the 5-year event free survival (EFS) and overall survival (OS) is (77.76±3.37)％ and (89.55±2.83)％,respectively.Median follow-up time is 5.33 y (3.75-7.70 y).Five patients (3.16％) died of complication,all of them were severe infections.Twenty-seven patients (17.09％) relapsed,including 13 bone marrow relapse (8.23％),5 testis relapse (5.32％ of boys,2 of unilateral and 3 bilateral),6 central nerve system relapse (CNS,3.80％),1 relapse in both bone marrow and CNS,1 relapse in both bone marrow and testis,and 1 right ovary and fallopian tube relapse.Relapse is related to positive minimal residual disease.Two cases (1.27％) occurred second tumors,4 patients (2.53％) gave up treatment in complete remission without special reasons.Conclusions The EFS and life quality of SCMC-ALL-2005 protocol in the treatment of childhood low-risk ALL is satisfactory.The treatment-related mortality rate is lower,and the long-term EFS is higher than that of XH-99 protocol.