2015-AML03化疗方案治疗急性髓细胞白血病患儿的疗效及预后影响因素分析  

Analysis of Curative Effect and Prognostic Factors of 2015-AML03 Chemotherapy Regimen for Children with Acute Myeloid Leukemia

作　　者：王成祥[1] 常绍鸿[1] 邢二庆 谢遂亮 杨玉京[1] 王向华 刘玉霞[1] WANG Chengxiang;CHANG Shaohong;XING Erqing(Xinxiang Central Hospital,Xinxiang,453000)

机构地区：[1]河南省新乡市中心医院,新乡医学院,453000

出　　处：《实用癌症杂志》2023年第3期510-514,共5页The Practical Journal of Cancer

摘　　要：目的 探讨2015-AML03化疗方案治疗急性髓系细胞白血病患儿的疗效及预后的影响因素。方法 选取急性髓细胞白血病患儿108例,采用2015-AML03化疗方案治疗,记录不同疗程的临床疗效[完全缓解(CR)与MRD阴性率]情况、并发症(败血症、肺炎、真菌感染、感染性休克、重度肺炎、肝功能损害、心肌损害、肾功能损害)。从纳入试验开始随访3年,对生存时间与预后影响因素分析。结果 108例患儿中,诱导化疗Ⅰ方案CR率85.19%(92/108)、MRD阴性率43.52%(47/108),诱导化疗Ⅱ方案CR率89.81%(97/108)、MRD阴性率58.33%(63/108);巩固化疗Ⅰ方案CR率92.78%(90/97)、MRD阴性率88.66%(86/97),巩固化疗Ⅱ方案CR率96.67%(87/90)、MRD阴性率90.00%(81/90)。108例AML患者4疗程化疗中发生败血症248例次,68例次肺炎,60例合并真菌感染,8例发生感染性休克,4例重度肺炎;38例出现肝功能损害,28例心肌损害,14例肾功能损害。从纳入试验开始随访3年,无一例患儿失访,108例AML患儿死亡29例,存活79例,化疗后进展61例,PFS:3~30.5个月,中位PFS 10.6个月,随访3个月时患者开始出现进展;OS:2~36个月,中位OS 14个月,随访2个月时患者开始出现死亡。死亡组与存活组在初诊WBC、初诊危险度、MRD等因素上差异具有统计学意义(P<0.05);经Logistics回归分析发现初诊WBC≥100×10^(9)/L、初诊中高危危险度、MRD≥0.1%是影响AML患儿预后的因素。结论 2015-AML03化疗方案疗程短,见效快,且未新增其他不可耐受的药物毒副作用。初诊WBC≥100、初诊中高危危险度、MRD≥0.1%是影响AML儿童的独立预后因素。Objective To explore the efficacy and prognostic factors of 2015-AML03 chemotherapy regimen in the treatment of children with acute myeloid leukemia.Methods 108 children with acute myeloid leukemia were selected and treated with 2015-AML03 chemotherapy scheme.The clinical efficacy(CR and negative rate of MRD) and complications(septicemia, pneumonia, fungal infection, septic shock, severe pneumonia, liver function damage, myocardial damage and renal function damage)of different treatments were recorded.The patients were followed up for 3 years from the beginning of the trial, and the survival time and prognostic factors were analyzed.Results Among 108 children, the CR rate of induction chemotherapy I was 85.19%(92/108),the negative rate of MRD was 43.52%(47/108),the CR rate of induction chemotherapy II was 89.81%(97/108),and the negative rate of MRD was 58.33%(63/108).CR rate of consolidation chemotherapy I was 92.78%(90/97),negative rate of MRD was 88.66%(86/97),CR rate of consolidation chemotherapy II was 96.67%(87/90),negative rate of MRD was 90.00%(81/90).108 AML patients had 248 cases of sepsis, 68 cases of pneumonia, 60 cases of fungal infection, 8 cases of septic shock, and 4 cases of severe pneumonia during 4 courses of chemotherapy;Liver function damage occurred in 38 cases, myocardial damage in 28 cases, and renal function damage in 14 cases.Follow up for 3 years from the beginning of the inclusion trial showed that none of the children lost the follow-up.Among 108 AML children, 29 died, 79 survived, and 61 progressed after chemotherapy.PFS:3~30.5 months, median PFS:10.6 months, and the patient began to progress after 3 months of follow-up.OS:2~36 months, with a median of 14 months.The patient began to die at 2 months of follow-up.There were statistically significant differences between the death group and the survival group in WBC,risk of initial diagnosis, MRD and other factors(P<0.05).Logistic regression analysis found that WBC≥100 at the initial diagnosis×10^(9)/L,high risk degree in initial di-ag

关 键 词：急性髓细胞白血病 2015-AML03化疗方案 临床疗效 预后 

分 类 号：R733.7[医药卫生—肿瘤]