CALLG2008方案治疗60岁以下初发成人急性B淋巴细胞白血病的临床研究  

Efficacy and safety of CALLG2008 protocol in treatment of patients with incipient acute B lymphoblastic leukemia

作　　者：张开峰[1,2] 韦菊英[1] 黄健[1] 俞文娟[1] 孟海涛[1] 麦文渊[1] 佟红艳[1] 金洁[1] 钱文斌[1] 

机构地区：[1]浙江大学附属第一医院血液科,杭州310003 [2]新昌县人民医院血液科

出　　处：《浙江医学》2016年第12期906-910,935,共6页Zhejiang Medical Journal

基　　金：浙江省卫生厅科研基金(2012KYA069);浙江省中医药管理局科研基金(2012ZA073);浙江省重点科技创新团队(2011R50015)

摘　　要：目的评价按照中国成人急性淋巴细胞白血病(ALL)协作组制定的成人ALL序贯化疗整体方案(CALLG2008)治疗60岁以下初发成人B细胞ALL(B-ALL)的疗效,并比较分析不同危险因素分层亚组之间的治疗结果,观察异基因造血干细胞移植(Allo-SCT)对患者生存期的影响。方法对2009年3月至2014年8月接受CALLG2008方案治疗的60岁以下初发成人B-ALL患者39例进行随访,分析接受该方案诱导治疗后患者的完全缓解(CR)率、毒性反应和总生存(OS)、无事件生存(EFS)情况。结果39例患者中3例早期死亡,其余36例中33例获CR,1个疗程CR率为91.7%。随访至2014年8月1日,中位随访时间25个月;预计3年OS率为53.7%,EFS率为45.6%。预后因素分析提示,患者年龄>35岁以及初诊时白细胞计数>30×109/L是预后的不良因素。Allo-SCT能显著延长患者尤其是高危组患者的OS期及EFS期。主要不良反应为血液学毒性反应,诱导治疗中有88.9%(32/36)出现Ⅳ级血液学毒性反应。结论 CALLG2008方案治疗60岁以下成人B-ALL有较高CR率及长期生存。患者年龄和初诊时白细胞计数是影响预后的重要因素。Allo-SCT可明显延长OS期。Objective To evaluate the efficacy and safety of CALLG2008 protocol, which was suggested by China Collaborative Group of Acute Lymphoblastic Leukemia, in patients with incipient acute B lymphoblastic leukemia. Methods The clinical data of 39 patients aged〈60 years with acute B lymphoblastic leukemia （B- ALL） receiving CALLG2008 protocol were reviewed. The event- free survival （EFS） , overal survival （OS） rate and adverse events were assessed. Results Thirty- three （91.7%） patients showed complete remission. Median OS was 25 months. Three years estimated OS and EFS rates were 53.7%and 45.6%, respectively （median fol ow- up, 25 months）. Age〉35 years and white blood cel count〉30×109/L at diagnosis were associated with shorter OS and EFS. Al ogeneic hematopoietic stem cel transplantation significantly prolonged the OS and EFS, especial y in patients with high risks. Conclusion These data indicate that CALLG2008 protocol for ALL exhibits benefit in the improvement of outcomes of adult B- ALL patients.

关 键 词：急性淋巴细胞白血病 化疗 预后 PH染色体 

分 类 号：R733.71[医药卫生—肿瘤]