CCLG-ALL 2008(高危组)方案治疗儿童混合表型急性白血病的疗效及安全性分析  

Clinical Effect and Safety of CCLG-ALL 2008(high risk group)Protocol in the Treatment of Childhood Mixed Phenotype Acute Leukemia

作　　者：郑湧智 乐少华[1] 郑浩[1] 华雪玲[1] 陈再生[1] 郑灵[1] 陈彩[1] 李梅[1] 蔡春霞 杨景辉[1] 陈以乔[1] 高琴丽[1] 陈莹莹[1] 潘丽丽[1] 李健[1] 胡建达[1] ZHENG Yong-Zhi;LE Shao-Hua;ZHENG Hao;HUA Xue-Ling;CHEN Zai-Sheng;ZHENG Ling;CHEN Cai;LI Mei;CAI Chun-Xia;YANG Jing-Hui;CHEN Yi-Qiao;GAO Qin-Li;CHEN Ying-Ying;PAN Li-Li;LI Jian;HU Jian-Da(Department of Pediatric Hematology,Fujian Institute of Hematology,Fujian Provincial Key Laboratory,Fujian Medical University Union Hospital,Fuzhou 350001,Fujian Province,China)

机构地区：[1]福建医科大学附属协和医院小儿血液科,福建省血液病研究所,福建省血液病学重点实验室,福建福州350001

出　　处：《中国实验血液学杂志》2021年第1期49-55,共7页Journal of Experimental Hematology

基　　金：福建省血液医学中心建设项目[闽政办(2017)4号]。

摘　　要：目的:总结中国儿童白血病协作组(CCLG)-ALL2008(高危组)方案治疗儿童混合表型急性白血病(MPAL)的疗效及安全性。方法:回顾性分析2013年1月到2017年12月本院收治的15例初诊MPAL患儿的临床资料,给予CCLG-ALL 2008(高危组)方案治疗。结果:1例诊断后即放弃治疗,14例诱导缓解治疗后,3例放弃继续治疗,5例继续规则化疗,6例接受异基因造血干细胞移植(allo-HSCT)。诱导缓解治疗第33天完全缓解(CR)率为85.7%;严重不良事件发生率71.4%,治疗相关死亡率为14.3%;复发率21.4%,复发中位时间12(9.7-18.4)个月。除了4例放弃治疗患儿,其他11例患儿5年无事件生存(EFS)率为(54.5±15.0)%;6例诱导后接受HSCT和4例只接受巩固化疗患儿5年EFS率分别为(83.3±15.2)%和(25.0±21.7)%,差异有统计学意义(P=0.033)。结论:儿童MPAL接受CCLG-ALL2008(高危组)方案化疗,诱导缓解率较高,但严重不良事件发生率亦高,缓解后行allo-HSCT可改善远期预后。Objective;To investigate the clinical effect and safety of Chinese Children's Leukemia Group(CCLG)-ALL 2008(high risk group)protocol in the treatment with childhood Mixed phenotype acute leukemia(MPAL).Methods;The clinical data of 15 new diagnosed patients with MPAL treated in our hospital from January 2013 to December 2017 were retrospectively analyzed,and received CCLG-ALL 2008(high risk group)protocol chemotherapy.Results:One patient gave up treatment after diagnosed,and 14 children with MPAL after induction remission chemotherapy,3 patients gave up,and 5 patients received consolidation chemotherapy,and 6 patients received allogeneic hematopoietic stem cell transplantation(allo-HSCT).The complete remission(CR)rate was 85.7%at d33 of induction remission chemotherapy.The serious adverse event and treatment-related mortality(TRM)rate was 71.4%and 14.3%,respectively.The recurrence rate was 21.4%and the median time of relapse was 12(9.7-18.4)months.Except for 4 patients who gave up treatment,the 5-year event-free survival(EFS)rate in the other 11 patients was(54.5±15.0)%.The 5 years EFS of 4 patients who received consolidation chemotherapy was significantly lower than the 6 patients who received allo-HSCT after CR(25.0%±21.7%vs 83.3%±15.2%,P=0.033).Conclusion;The CCLG-ALL2008(for high-risk group)protocol in treatment of children with MPAL can get a high CR rate,but also with a high incidence of SAE.The patients received allo-HSCT after CR may have a good prognosis.

关 键 词：混合表型急性白血病 儿童 联合化疗 造血干细胞移植 疗效 

分 类 号：R733.71[医药卫生—肿瘤]