SCMC-ALL-2005方案治疗儿童B细胞型急性淋巴细胞白血病疗效观察  

Outcome of childhood B-cell acute lymphoblastic leukemia treated with SCMC-ALL-2005 protocol

作　　者：徐慧娟[1] 姜健[1] 仲任[1] 李学荣[1] 卢愿[1] 汤静燕[2] 蒋慧[3] 袁晓军[4] 王宁玲[5] 孙立荣[1] 

机构地区：[1]青岛大学附属医院血液儿科,山东青岛266003 [2]上海交通大学医学院附属上海儿童医学中心血液/肿瘤科,上海200127 [3]上海交通大学附属上海市儿童医院血液科,上海200040 [4]上海交通大学医学院附属新华医院儿童血液/肿瘤科,上海200092 [5]安徽医科大学附属第二医院儿科,安徽合肥230601

出　　处：《临床儿科杂志》2014年第11期1028-1033,共6页Journal of Clinical Pediatrics

摘　　要：目的评估上海儿童医学中心-急性淋巴细胞性白血病-2005(SCMC-ALL-2005)治疗方案治疗儿童B细胞型ALL的疗效。方法按照SCMC-ALL-2005方案,5家医院对2005年5月1日至2009年4月30日新发B细胞型ALL患儿进行诊断、治疗和随访。结果研究期间共收治B细胞型ALL患儿601例,539例(89.68%)随访至2011年9月30日。601例患儿中,低危284例、中危231例、高危86例,均按照诊疗建议治疗。诱导期间缓解率为98.84%(7例未缓解),第一次事件发生时的中位时间为35个月(2.94年),至随访终止日的539例随访病例中共完成治疗403例(74.77%);低危组完成治疗223例(86.43%),中危组150例(73.17%),高危组30例(39.47%),三组间的差异有统计学意义(P=0.001)。采用KaplanMeier方法评估患儿随访3年的总生存率为(83.3±1.8)%,3年无事件生存(EFS)率为(79.2±1.9)%;随访5年总生存率为(79.5±3.3)%,5年EFS率为(70.9±3.7)%。低、中、高危三组间3年及5年EFS率差异有统计学意义(P均<0.05)。结论SCMC-ALL-2005方案治疗儿童B细胞型ALL的疗效比较满意,多中心协作有助于儿童白血病的规范化治疗。Objective To analyze the outcome of childhood B-cell acute lymphoblastic leukemia treated （ALL） with SCMC-ALL-2005 protocol. Methods Newly diagnosed B-cell ALL from May 1, 2005 to April 30, 2009 in ifve hospitals were treated and followed up according to SCMC-ALL-2005 protocol. Results A total of 601 cases with newly diagnosed B-cell ALL were enrolled. Among them, 539 cases （89.68%） were followed up until September 30, 2011. In 601 patients, there were 284 low-risk cases （LR group）, 231 moderate-risk cases （MR group） and 86 high-risk cases （HR group） which were treated with SCMC-ALL-2005 protocol. The total complete remission rate during the period of induction was 98.84%and 7 cases did not achieve complete remission. The median time of the ifrst event occurring was 35 months （2.94 years）. Among 539 cases completing follow-up, 403 cases （74.77%） completed treatment including 223 cases （86.43%） in LR group, 150 cases （73.17%） in MR group and 30 cases （39.47%） in HR group. The rate of cases completing treatment was signiifcantly different among three groups （P=0.001）. The completion rate was highest in LR group and lowest in HR group. The 3-year overall survival （OS） rate was （83.3±1.8）%, and the 3-year EFS （event-free survival） rate was （79.2±1.9）%using a Kaplan-Meier method. The 5-year OS rate was （79.5±3.3）%, and the 5-year EFS rate was （70.9±3.7）%. There were signiifcant differences in 3-year EFS rate and 5-year EFS rate among three groups （P〈0.05）. Conclusions Childhood B-ALL treated with SCMC-ALL-2005 protocol achieved a better therapeutic effect and prognosis. The multi-center collaborative research is useful for the standard treatment of ALL.

关 键 词：急性淋巴细胞白血病 B细胞型 SCMC-ALL-2005方案 儿童 

分 类 号：R733.71[医药卫生—肿瘤]