儿童中高危T淋巴母细胞淋巴瘤与急性淋巴细胞白血病30例临床分析  

Prognostic factors and treatment outcome of the pediatric intermediate and high risk T-Lymphoblastic lymphoma/acute lymphoblastic leukemia-a clinical analysis of 30 cases

作　　者：亓凯[1] 黎阳[1] 方建培[1] 马磊[1] 黄科[1] 郭海霞[1] 黄绍良[1] 周敦华[1] 陈纯[1] 熊稀霖[1] 徐宏贵[1] 薛红漫[1] 

机构地区：[1]中山大学孙逸仙纪念医院儿科血液朋中瘤专科,广东广州510120

出　　处：《中国实用儿科杂志》2015年第5期377-382,共6页Chinese Journal of Practical Pediatrics

摘　　要：目的研究儿童中高危T淋巴母细胞淋巴瘤/急性淋巴细胞白血病（T-LBL/ALL）的临床疗效及预后。方法回顾性研究自2002—2012年,在中山大学孙逸仙纪念医院儿科首诊的30例中高危T-LBL/ALL患儿进行分层治疗的疗效及预后。结果本组30例T-LBL/ALL患儿中T-LBL 5例,T-ALL 25例,男22例,女8例,男女比例2.75∶1;中位发病年龄9岁;危险度分级有中危（IR）组12例,高危（HR）组18例,中位随访时间36.4个月（3-108个月）;诱导化疗第33天获得完全缓解28例,复发7例,死亡9例（IR组死亡1例,HR组死亡8例）。3年总生存率（OS）和无事件生存率（EFS）分别为46.7%及42.1%。结论本研究化疗方案治疗儿童中高危T-LBL/ALL取得较好的疗效,同时需要对患儿进行精确的评估,发现预后不良的因素,给予个体化的化疗以提高生存率。Objective To evaluate the prognostic factors and the therapeutic effectiveness in 30 cases of pediatric intermediate risk（IR）and high risk（HR）T-LBL/ALL. Methods Thirty patients in Sun Yet-Sen Memorial Hospital,Sun Yet-Sen University admitted from 2002 to 2012 were retrospectively studied. Evaluate patients＇ 3-year overall survival（OS）rate,3-year event-free survival（EFS）rate,recurrence rate and mortality rate with Kaplan-Meier analysis;compare inner-group patients＇ OS and EFS difference and survival curve with Log-Rank test;all data was processed by SPSS 17.0. Results Among the 30 cases of T-LBL/ALL,5 were T-LBL and 25 were T-ALL. Twenty-two were male and 8 were female. The median age at diagnosis was 9 years. Twelve children were classified as intermediate-risk and 18 were high-risk. Twenty-eight children completely remitted on day 33 of induction chemotherapy while 7 children relapsed. After a median follow-up of 36.4 months（3-108 months）,9 children were dead,including 1 child from intermediate-risk group and 8 from high-risk group. The estimated 3-year overall survival rate and event free survival rate were 46.7% and 42.1%,respectively. Conclusion This chemotherapy regimen has good effect on children with intermediate and high risk T-LBL/ALL. Successfully screening the risk factors is beneficial for designing the prognostic analytical model and choosing the optimal solutions for the patients in order to improve survival rate.

关 键 词：T淋巴母细胞淋巴瘤 白血病 儿童 化疗 预后 

分 类 号：R72[医药卫生—儿科]