同济95方案治疗儿童急性淋巴细胞白血病和晚期淋巴瘤远期疗效研究  

Long-term curative effect of childhood acute lymphoblastic leukemia and Non-Hodgkin's lymphoma treated with Tongji-95 protocol.

作　　者：谢晓恬[1] 石苇[1] 李本尚[1] 

机构地区：[1]同济大学附属同济医院小儿血液肿瘤科,上海200065

出　　处：《中国实用儿科杂志》2002年第12期734-737,共4页Chinese Journal of Practical Pediatrics

摘　　要：目的　为了提高儿童急性淋巴细胞白血病 (ALL)和非霍奇金淋巴瘤 (NHL)的远期疗效 ,在总结国内外研究进展的基础上 ,设计制定同济 95方案 (TJ95 ) ,并以多年临床观察资料分析与判定其远期疗效。方法　儿童ALL和晚期NHL共 5 1例 ,其中ALL 32例 ,晚期NHL 19例。分别应用TJ95 1方案治疗儿童ALL、Ⅳ期和Ⅲ期T细胞淋巴瘤 ;TJ95 2方案治疗Ⅲ期B细胞淋巴瘤。采用积极的化疗副反应综合防治措施 ,以保证强烈化疗顺利进行 ,随访观察远期疗效。结果　初治完全缓解 (CR)率为 10 0 %。可供分析远期疗效的病例共 4 8例 (3例失访 ) ,其中 38例仍持续完全缓解 (CCR)中 ,平均CCR时间为 6 0 1个月 ,CCR率为 79 17% ;按Kaplan Meier函数分析法预测 6年以上CCR率为 79 0 5 %。因采用有效的化疗副反应综合防治措施 ,未发生化疗相关死亡。结论　TJ95方案远期疗效显著 ,CCR率接近发达国家水平。毒副反应可以有效防治 ,患儿能够耐受 ,适用于我国儿童ALL和晚期NHL的长期治疗 ,值得推广。Objective To investigate the long term curative effect of childhood acute lymphoblastic leukemia(ALL)and aggressive Non Hodgkin's lymphoma(NHL)treated with Tongji 95 protocol.Methods Fifty one consecutive newly diagnostic children(ALL 32,NHL 19)were treated with intensive chemotherapy protocol Tongji95(TJ95).The Tongji95 1 protocol was used to treat childhood ALL,stage Ⅳ NHL,and stage Ⅲ T cell NHL,while the Tongji95 2 protocol was used to treat stage Ⅲ B cell NHL.Preventive measurements as well as supportive cares were taken against infection and other side effects.The long term curative effect was surveyed through follow ups.Results The complete remission(CR)was 100%,and the continuous complete remission(CCR)was 79 17%,The projected more than 6 years CCR rate was 79 05% by Kaplan Meier method.The toxicity is endurable,no evidence of renal,central nervous system toxicity were observed,no chemotherapy related death occurred,and almost all the children could accomplish the overall course.Conclusion As a comprehensive systemic and periodic intensified therapeutical protocol,Tongji95 protocol is worthy of summarizing and popularizing.

关 键 词：同济95方案 治疗 儿童 急性淋巴细胞白血病 晚期淋巴瘤 疗效 

分 类 号：R733.71[医药卫生—肿瘤] R733[医药卫生—临床医学]