Re-induction with modified CLAG regimen in relapsed or refractory acute myeloid leukemia in children bridging to allogeneic hematopoietic stem cell transplantation  

作　　者：Na Zhang Jing-Bo Shao Hong Li Jing-Wei Yang Kai Chen Jia-Shi Zhu Hui Jiang 

机构地区：[1]Department of Hematology and Oncology,Shanghai Children's Hospital,Shanghai Jiao Tong University,No.24,lane 1400,West Beijing Road,Shanghai 200040,China

出　　处：《World Journal of Pediatrics》2020年第2期152-158,共7页世界儿科杂志（英文版）

基　　金：This study was supported by a grant from Shanghai Science and Technology Committee Projects No.14411950602 and No.18ZR1431200.

摘　　要：Background The prognosis for relapsed or refractory acute myeloid leukemia(RR-AML)in children is poor,and the preferred salvage chemotherapy is unclear.One regimen is cladribine,cytarabine,and granulocyte-colony stimulating factor(CLAG),but little is known about its efficacy and safety in children with RR-AML.Methods We enrolled RR-AML patients aged 0-18 years who received modified CLAG regimen for re-induction between July 1,2015 and April 1,2018,or conventional induction between August 1,2011 and April 1,2018.Patients were followed up to March 31,2019.Patients underwent allogeneic stem cell transplantation(allo-SCT)or chemotherapy after the induction of complete remission(CR).The CR rate,survival,and side effects were analyzed.Results The CR rate for induction was 66.7%after one cycle and 75.0%after two cycles of the CLAG regimen in 12 children.The nine children who received conventional chemotherapy had a CR rate of 22.2%after one cycle and 33.3%after two cycles(P=0.087 vs.CLAG).The 3-year event-free survival(EFS)of the CLAG group and the conventional treatment group were 44.4±15.7%and 22.2±13.8%(P=0.112).The 3-year overall survival of the two groups were 59.5±16.2%and 22.2%±13.8%(P=0.057).The 3-year EFS for allo-SCT and chemotherapy after CLAG regimen was 66.7±19.2%and 25.0±21.7%(P=0.015).A single case of chemotherapy-related death was recorded.Conclusion Our data suggest a promising CR rate using CLAG salvage treatment in childhood RR-AML.Allo-SCT after CR may improve the long-term outcome in these patients.

关 键 词：Acute myeloid leukemia CHILDREN CLADRIBINE REFRACTORY RELAPSED 

分 类 号：R725[医药卫生—儿科]