强化维持化疗方案治疗Ⅲ-Ⅳ期儿童青少年淋巴母细胞淋巴瘤患者的疗效及安全性  

Efficacy and Safety of Intensive Maintenance Chemotherapy Regimen for Treatment of Children and Adolescents with Lymphoblastic Lymphoma for StageⅢ-Ⅳ

作　　者：刘艳芬 柳善伟 孙宪军 LIU Yan-Fen;LIU Shan-Wei;SUN Xian-Jun(Department of Pediatrics,Jinan Municipal People′s Hospital,Jinan 271100,Shandong Province,China;Department of Hematology,Jinan Municipal People′s Hospital,Jinan 271100,Shandong Province,China;Department Neonatology,Jinan Municipal People′s Hospital,Jinan 271100,Shandong Province,China)

机构地区：[1]济南市人民医院儿科,山东济南271100 [2]济南市人民医院血液内科,山东济南271100 [3]济南市人民医院新生儿科,山东济南271100

出　　处：《中国实验血液学杂志》2020年第2期524-528,共5页Journal of Experimental Hematology

摘　　要：目的:探讨强化维持化疗方案治疗Ⅲ-Ⅳ期儿童青少年淋巴母细胞淋巴瘤(LBL)患者的疗效及安全性。方法:回顾性分析本院2009年7月-2015年7月收治的87例Ⅲ-Ⅳ期儿童青少年LBL患者的临床资料。87例患者均采用改良NHL-BFM-90/-95方案治疗,其中62例在维持治疗阶段给予常规化疗方案设为对照组,25例在维持治疗阶段给予强化化疗方案设为强化方案组,比较2组随访5年无事件生存(EFS)率、总生存(OS)率,复发死亡情况及毒副作用发生情况。结果:2组患者随访5年EFS率和OS率比较差异无统计学意义(P>0.05);2组临床分期Ⅲ期/Ⅳ期、免疫分型T-LBL/B-LBL及中危/高危组间随访5年EFS率、OS率比较差异无统计学意义(P>0.05);2组患者随访复发率和死亡率比较差异无统计学意义(P>0.05)。强化方案组维持治疗期间Ⅲ-Ⅳ级骨髓抑制发生率显著高于对照组(P<0.05)。结论:强化维持化疗方案用于Ⅲ-Ⅳ期儿童青少年LBL患者治疗较常规维持化疗方案并未增加生存获益,且可能导致严重骨髓抑制发生风险升高。Objective:To investigate the efficacy and safety of intensive maintenance chemotherapy regimen for treatment of children and adolescents with lymphoblastic lymphoma at stageⅢ-Ⅳ.Methods:The clinical data of 87 children and adolescents with lymphoblastic lymphoma at stageⅢ-Ⅳwere analyzed retrospectively from July 2009 to July 2015.All patients received the treatment of modified NHL-BFM-90/95 regimen,and divided into 2 groups:the control group(62 patients)with conventional maintenance chemotherapy regimen,and the intensive regimen group(25 patients)with intensive maintenance chemotherapy regimen.The event-free survival(EFS)rate and overall survival(OS)rate during follow-up for 5 years,recurrence rate,mortality,and toxic and side effects were compared between 2 groups.Results:There was no significant difference in the EFS rate and OS rate after follow-up for 5 years between 2 groups(P>0.05).There was no significant difference in the EFS rate and OS rate after follow-up for 5 years between clinical stage forⅢandⅣ,immunotyping for T-LBL and B-LBL and morderate risk and high risk in 2 groups(P<0.05).There was no significant difference in the recurrence rate and mortality after followed-up between 2 groups(P>0.05).The incidence of myelosuppression forⅢ-Ⅳgrade during maintenance therapy in intensive regimen group were significantly higher than that in control group(P<0.05).Conclusion:Compared with conventional maintenance chemotherapy regimen,intensive maintenance chemotherapy regimen in the treatment of children and adolescents with lymphoblastic lymphoma for stageⅢ-Ⅳpossess the same survival benefit,but may cause increased severe bone marrow suppression risk.

关 键 词：淋巴母细胞淋巴病 儿童 青少年 维持化疗 生存时间 

分 类 号：R733.1[医药卫生—肿瘤]