中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2014年
12期
1083-1089
,共7页
孙晓非%甄子俊%朱佳%王娟%路素英%夏奕%孙斐斐%陈燕%张飞
孫曉非%甄子俊%硃佳%王娟%路素英%夏奕%孫斐斐%陳燕%張飛
손효비%견자준%주가%왕연%로소영%하혁%손비비%진연%장비
前体细胞淋巴母细胞白血病淋巴瘤%儿童%青少年%抗肿瘤联合化疗方案%存活率
前體細胞淋巴母細胞白血病淋巴瘤%兒童%青少年%抗腫瘤聯閤化療方案%存活率
전체세포림파모세포백혈병림파류%인동%청소년%항종류연합화료방안%존활솔
Precursor cell lymphoblastic leukemia-lymphoma%Childhood%Adolescent%Antineoplastic combined chemotherapy protocols%Survival
目的 评估改良NHL-BFM-90方案治疗儿童青少年淋巴母细胞淋巴瘤(LBL)患者的远期疗效.方法 以1998年3月至2010年12月收治的107例初治LBL患者(年龄≤18岁)为研究对象,根据临床分期和早期诱导化疗疗效将患者分为低危、中危和高危组,采用改良NHL-BFM-90方案化疗.不同分组患者采用不同强度化疗.总疗程2年.结果 107例患者中,男79例(73.8％),女28例(26.2％),中位年龄10(2.5～18)岁.Ⅰ/Ⅱ期者6例(5.6％),Ⅲ/Ⅳ期者101例(94.4％).低危组6例(5.6％),中危组76例(71.0％),高危组25例(23.4％).B-LBL 26例(24.3％),T-LBL 81例(75.7％).中位随访时间61(1～186)个月.24例患者死亡.5年无事件生存率和总生存率分别为:全组75.5％和77.8％;低危组100.0％和100.0％;中危组84.4％和87.5％;高危组44.0％和44.0％; T-LBL患者72.0％和73.5％;B-LBL患者86.4％和88.5％.骨髓抑制是主要不良反应,需要积极处理.结论 改良NHL-BFM-90方案对低危和中危儿童青少年LBL患者有很好的疗效,T-LBL和B-LBL患者疗效相似.高危患者疗效差,需要探讨新的治疗方法.
目的 評估改良NHL-BFM-90方案治療兒童青少年淋巴母細胞淋巴瘤(LBL)患者的遠期療效.方法 以1998年3月至2010年12月收治的107例初治LBL患者(年齡≤18歲)為研究對象,根據臨床分期和早期誘導化療療效將患者分為低危、中危和高危組,採用改良NHL-BFM-90方案化療.不同分組患者採用不同彊度化療.總療程2年.結果 107例患者中,男79例(73.8％),女28例(26.2％),中位年齡10(2.5～18)歲.Ⅰ/Ⅱ期者6例(5.6％),Ⅲ/Ⅳ期者101例(94.4％).低危組6例(5.6％),中危組76例(71.0％),高危組25例(23.4％).B-LBL 26例(24.3％),T-LBL 81例(75.7％).中位隨訪時間61(1～186)箇月.24例患者死亡.5年無事件生存率和總生存率分彆為:全組75.5％和77.8％;低危組100.0％和100.0％;中危組84.4％和87.5％;高危組44.0％和44.0％; T-LBL患者72.0％和73.5％;B-LBL患者86.4％和88.5％.骨髓抑製是主要不良反應,需要積極處理.結論 改良NHL-BFM-90方案對低危和中危兒童青少年LBL患者有很好的療效,T-LBL和B-LBL患者療效相似.高危患者療效差,需要探討新的治療方法.
목적 평고개량NHL-BFM-90방안치료인동청소년림파모세포림파류(LBL)환자적원기료효.방법 이1998년3월지2010년12월수치적107례초치LBL환자(년령≤18세)위연구대상,근거림상분기화조기유도화료료효장환자분위저위、중위화고위조,채용개량NHL-BFM-90방안화료.불동분조환자채용불동강도화료.총료정2년.결과 107례환자중,남79례(73.8％),녀28례(26.2％),중위년령10(2.5～18)세.Ⅰ/Ⅱ기자6례(5.6％),Ⅲ/Ⅳ기자101례(94.4％).저위조6례(5.6％),중위조76례(71.0％),고위조25례(23.4％).B-LBL 26례(24.3％),T-LBL 81례(75.7％).중위수방시간61(1～186)개월.24례환자사망.5년무사건생존솔화총생존솔분별위:전조75.5％화77.8％;저위조100.0％화100.0％;중위조84.4％화87.5％;고위조44.0％화44.0％; T-LBL환자72.0％화73.5％;B-LBL환자86.4％화88.5％.골수억제시주요불량반응,수요적겁처리.결론 개량NHL-BFM-90방안대저위화중위인동청소년LBL환자유흔호적료효,T-LBL화B-LBL환자료효상사.고위환자료효차,수요탐토신적치료방법.
Objective To evaluate the long-term survival of children and adolescents with lymphoblastic lymphoma (LBL) treated by a modified NHL-BFM-90 protocol.Methods From March 1998 to November 2010,107 untreated patients with LBL (age ＜ 18 years) were enrolled and stratified into three groups (R1,R2 and R3),according to the stage of disease and response to induction chemotherapy.All patients received different intensive chemotherapy regimens based on a modified NHL-BFM-90 protocol.Total treatment duration was 2 years.Results Of the 107 patients,79 were boys and 28 were girls,with a median age of 10 years (range 2.5-18 years).Six patients (5.6％) were stage Ⅰ/Ⅱ,101 (94.4％) stage Ⅲ/Ⅳ.The R1,R2 and R3 groups accounted for 5.6％,71.0％ and 23.4％,respectively.75.7％ of the patients had T-LBL,and 24.3％ was B-LBL.At a median follow-up duration of 60 months (range 1-186 months),24 patients died.The 5-year event-free survival (EFS) and overall survival (OS) were 75.5％ and 77.8 ％ for all patients,100.0％ and 100.0％ for group R1,84.5％ and 87.5 ％ for R2,44.0％ and 44.0％ for R3,72％ and 73.5％ for T-LBL,86.4％ and 88.5％ for B-LBL,respectively.Myleosuppression was the major toxicity and need aggressive management.Conclusion The modified NHL-BFM-90 protocol is an effective therapy for children and adolescents with LBL in low and intermediate risk.T-LBL had the similar outcomes as B-LBL did.The patients in high-risk group had a poor survival and new protocols are needed.
