CAMSBDH-ALL方案治疗儿童急性淋巴细胞白血病的中长期疗效观察  

Long-term efficacy of CAMSBDH-ALL chemotherapy protocol for the treatment of childhood acute lymphoblastic leukemia

作　　者：陈晓娟 邹尧 陈玉梅 杨文钰 王书春 郭晔 张丽 阮敏 刘晓明 刘芳[1] 刘天峰 张家源 戚本泉 常丽贤 竺晓凡 

机构地区：[1]中国医学科学院血液学研究所/血液病医院/儿童血液病诊疗中心,天津300020

出　　处：《中国当代儿科杂志》2014年第10期1019-1024,共6页Chinese Journal of Contemporary Pediatrics

基　　金：天津市科技支撑计划(12ZCDZSY18100)

摘　　要：目的回顾性分析CAMSBDH-ALL方案治疗儿童急性淋巴细胞白血病(ALL)的中长期疗效。方法 1999年1月至2007年12月间初诊儿童ALL共318例,2002年12月前收治的83例患儿采用CAMSBDH-ALL99方案治疗,其中标危(SR)患儿48例,高危(HR)患儿35例;之后收治的235例患儿采用CAMSBDH-ALL03方案,其中SR患儿131例,HR患儿104例。99方案采用传统化疗;03方案在99方案的基础上进行调整。结果 03方案组中长期OS率及EFS率均明显高于99方案组 (均P<0.01);SR及HR患儿03方案组中长期OS率及EFS率亦均显著高于99方案组(均P<0.01);03方案组复发率(28.9%)显著低于99方案组(50.6%)(P<0.05),且病死率(28.5%)亦显著低于99方案组(56.6%)(P<0.05)。结论 03方案疗效明显优于99方案,即能明显降低ALL患儿复发率和病死率,提高患儿中长期生存率。Objective To study the long-term efficacy of CAMSBDH-ALL chemotherapy protocol for the treatment of childhood acute lymphoblastic leukemia （ALL）. Methods Three hundred and eighteen children who were newly diagnosed with ALL between January 1999 and December 2007 were enrolled in this study. Among the 318 children, 83 children who hospitalized before December 2002 were treated with CAMSBDH-ALL99 protocol, including 48 patients of standard risk and 35 patients of high risk. The patients （n=235;131 in standard risk and 104 in high risk） who hospitalized after December 2002 were treated with CAMSBDH-ALL03 protocol. Patients in the CAMSBDH-ALL99 protocol group were treated with conventional chemotherapy. CAMSBDH-ALL03 protocol was modiifed based on the CAMSBDH-ALL99 protocol. Results The long-term overall survival （OS） and event-free-survival （EFS） in the CAMSBDH-ALL03 group was signiifcantly higher than in the CAMSBDH-ALL99 （P〈0.01）. The long-term OS and EFS of standard risk and high risk patients in the CAMSBDH-ALL03 protocol group were signiifcantly higher than in the CAMSBDH-ALL99 protocol group （P〈0.01）. The CAMSBDH-ALL03 protocol group showed a significantly lower recurrence rate （28.9%） than in the CAMSBDH-ALL99 protocol group （50.6%） （P〈0.05）. The mortality rate in the CAMSBDH-ALL03 protocol group was 28.5%vs 56.6%in the CAMSBDH-ALL99 protocol group （P〈0.05）. Conclusions The therapeutic effect of the CAMSBDH-ALL03 protocol is supior to the CAMSBDH-ALL99 protocol group for childhood ALL, with a higher long-term survival rate.

关 键 词：急性淋巴细胞白血病 化疗 儿童 

分 类 号：R733.71[医药卫生—肿瘤]