两种化疗方案对于TEL-AML1融合基因阳性儿童急性淋巴细胞白血病的疗效比较  

Comparison of Efficacy of two Chemotherapy Regimens for Acute Lymphoblastic Leukemia in TEL-AML1 Fusion

作　　者：张爱明 

机构地区：[1]湖北医药学院附属襄阳医院儿科,湖北襄阳441000

出　　处：《河北医学》2018年第2期206-211,共6页Hebei Medicine

摘　　要：目的:比较BCH-2003方案和CCLG-2008方案治疗急性淋巴细胞白血病确诊患儿(分子生物学标记为TEL-AML1)的临床疗效差异,为临床患儿根据实际病情选择合适诊治方案提供参考依据。方法:2012年8月至2015年12月期间,对在我院接受住院化疗的120例符合研究要求的急性淋巴细胞白血病确诊患儿(分子生物学标记为TEL-AML1)分别进行BCH-2003方案和CCLG-2008方案的治疗,每组患儿均为60例,比较两组患儿复发情况、血浆相关生化指标(VEGF、VEGFR、b FGF、MVD)、临床疗效的统计学差异。结果:两组患儿(BCH-2003方案组或CCLG-2008方案组)治疗前后VEGF、VEGFR、b FGF、MVD随时间迁移均发生了显著改变(均有P<0.05);治疗后两组患儿VEGF、VEGFR、MVD的差异均有统计学意义(均有P<0.05);两组患儿临床疗效的差异有统计学意义(P<0.05);两组患儿不良反应发生情况的比较,其神经系统症状、消化系统症状等不良反应的差异均有统计学意义(均有P<0.05);两组患儿预后复发情况危险程度比较有统计学意义(P<0.05);两组患儿免疫分型比较有统计学意义(P<0.05);两组患儿复发情况进行比较,其危险性、免疫分型、复发部位的差异均有统计学意义(均有P<0.05)。结论:BCH-2003方案相比CCLG-2008方案,治疗TEL-AML1融合基因阳性的急性淋巴细胞白血病儿童的短期临床疗效更好,但是CCLG-2008方案治疗过程中不良反应发生率及复发严重性均优于BCH-2003方案。Objective： To compare the difference of clinical efficacy between BCH-2003 program and CCLG-2008 regimen in the diagnosis of acute lymphoblastic leukemia（molecular marker TEL-AML1）,so as to provide reference for clinical children to choose appropriate diagnosis and treatment plan according to the actual condition. Methods： From August 2012 to December 2015,120 cases of children with acute lymphoblastic leukemia who were hospitalized for chemotherapy in our hospital were enrolled in the study. They were treated by BCH-2003 program and CCLG-2008 program. The children in each group were 60 cases,respectively. The molecular biological markers were TEL-AML1. The statistical differences in the recurrence of the two groups,the plasma related biochemical indexes（VEGF,VEGFR,b FGF,MVD）,and the clinical efficacy were compared. Results： The changes of VEGF,VEGFR,b FGF and MVD were significantly changed（P〈0.05） before and after treatment in the two groups. After treatment,the differences of VEGF,VEGFR and MVD in the two groups were statistically significant（p〈0.05）. The difference of clinical efficacy between the two groups was statistically significant（P 〈0.05）. The difference of adverse reactions between the two groups was statistically significant（P 〈0.05）. The difference of the risk of recurrence of the two groups was statistically significant（P 〈0.05）,and the difference of the immunophenotype of the two groups was statistically significant（P 〈0.05）. The recurrence of the two groups was compared,and the differences in risk,immune classification and recurrence were statistically significant（all P 〈0.05）. Conclusions： The short term clinical efficacy of the BCH-2003 regimen is better than the CCLG-2008 scheme in the treatment of children with TEL-AML1 fusion gene positive acute lymphoblastic leukemia. However,the incidence of adverse reactions and the severity of relapse in the CCLG-2008 regimen were better than that of the BCH-2003 regimen.

关 键 词：BCH-2003方案 CCLG-2008方案 TEL-AML1融合基因 儿童 急性淋巴细胞白血病 

分 类 号：R733.71[医药卫生—肿瘤]