儿童Burkitt淋巴瘤远期疗效分析  

Long-term efficacy analysis of Burkitt lymphoma in children

作　　者：李红[1] 邵静波[1] 杨静薇[1] 朱嘉莳[1] 张娜[1] 陈凯[1] 蒋慧[1] LI Hong;SHAO Jingbo;YANG Jingwei;ZHU Jiashi;ZHANG Na;CHEN Kai;JIANG Hui.(Department of Hematology and Oncology, Shanghai Children′s Hospital, Shanghai Jiao Tong University, Shanghai 200040, China)

机构地区：[1]上海市儿童医院,上海交通大学附属儿童医院血液肿瘤科,上海200040

出　　处：《中国小儿血液与肿瘤杂志》2021年第5期278-284,共7页Journal of China Pediatric Blood and Cancer

基　　金：编号:18ZR1431200。

摘　　要：目的回顾性评价61例儿童Burkitt淋巴瘤远期疗效及影响预后因素。方法2009年12月—2019年12月我科符合入组标准病例纳入研究,2009—2014年期间采用改良NHL-BFM95方案、2015—2019年后采用改良B-NHL2015国内方案,用Kaplan-Meier生存曲线分析疗效及COX多因素分析预后因素。结果61例患儿中位年龄7.9(1.8-15.5)岁,男50例(82%),女11例(18%),男、女比4.5∶1。5年EFS为(84.7±4.7)%,5年OS(91.2±3.8)%。Ⅱ、Ⅲ、Ⅳ期患儿的5年EFS分别为100%、(88.7±5.3)%、(70.5±11.3)%;5年OS分别为100%、(94.4±3.8)%、(79±10.8)%。Ⅲ期组单纯化疗患儿11例,联合利妥昔单抗25例,两组5年ESF分别为(72.7±13.4)%和(95.7±4.3)%(P=0.037),5年OS分别为(81.8±11.6)%和100%(P=0.029)。COX多因素分析LDH>4倍正常值(HR=2.702,95%CI:1.070~6.822,P=0.035)、侵犯脏器数≥4个(HR=6.562,95%CI:1.343~32.062,P=0.02)是影响儿童Burkitt淋巴瘤预后的独立危险因素。结论高剂量短疗程方案治疗Burkitt淋巴瘤疗效满意,联合利妥昔单抗可提高Ⅲ期患儿疗效。侵犯脏器数目≥4个和LDH>4倍正常值是预后不良的独立危险因素。Objective To evaluate the long term clinical efficacy and prognostic factors of 61 children with Burkitt lymphoma. Methods Children with Burkitt lymphoma who met the entry criteria were included in the study from December 2009 to December 2019. They were treated with NHL-BFM95 and B-NHL2015 regimen. The efficacy was analyzed by Kaplan-Meier survival curve and prognostic factors were analyzed by Cox multivariate analysis. Results The median age of 61 cases was 7. 9( 1. 8-15. 5) years,50 cases were male( 82%),11 cases were female( 18%),the ratio of male to female was 4. 5: 1. The 5-year EFS was( 84. 7 ± 4. 7) %,and the 5-year OS was( 91. 2 ± 3. 8) %. The 5-year EFS of children with stageⅡ、Ⅲ and Ⅳ were 100% 、( 88. 7 ± 5. 3) % 、( 70. 5 ± 11. 3) %,the 5-year OS was 100% 、( 94. 4 ± 3. 8) % 、( 79 ± 10. 8) %,respectively. 11/36 cases of stage Ⅲ were treated with chemotherapy alone and 11/36 cases were treated with rituximab and chemotherapy. The EFS of the two groups were( 72. 7 ± 13. 4) % 、( 95. 7 ± 4. 3) %( P = 0. 037),5-year OS was( 81. 8 ± 11. 6) % 、100%( P = 0. 029). Cox multivariate analysis showed that LDH level and involved organs more than 4 were independent risk factors for the prognosis of children with Burkitt lymphoma. Conclusions The efficacy of high dose and short course regimen is satisfied for children with Burkitt,and rituximab can improve the efficacy for children with Burkitt of stage Ⅲ. Involved organs more than 4 and LDH level more than 4 times are independent risk factors for poor prognosis.

关 键 词：儿童 BURKITT淋巴瘤 利妥昔单抗 无事件生存 预后 

分 类 号：R73[医药卫生—肿瘤]