儿童急性淋巴细胞白血病3年临床总结  

The clinical study of childhood acute lymphoblastic leukemia with the new protocol in recent three years

作　　者：于洁[1] 徐酉华[1] 宪莹[1] 戴碧涛[1] 李兴[1] 陆玲玲[1] 

机构地区：[1]重庆医科大学附属儿童医院血液肿瘤科,400014

出　　处：《重庆医学》2003年第10期1326-1329,共4页Chongqing medicine

摘　　要：目的　分析重医儿童医院近 3年收治的儿童急性淋巴细胞白血病 (ALL)病例 ,初步评估 1 999年全国ALL诊疗建议的方案的应用效果。方法　 2 0 0 0年 1月～ 2 0 0 3年 4月共收治初发ALL 1 92例 ,参照 1 999全国诊疗建议进行诊断、分型及治疗 ,进行MIC相关检测 ,并进行比较分析。结果　近 3年收治ALL病例数逐年增加 ;婴儿患者中高WBC者为 77.78% ,而 1 0岁以上组为 7.6 8%。B ALL和T ALL分别占 5 9.89%和 7.76 % ,合并髓系标志表达者 1 1 .6 5 %。具有染色体数目或结构异常的患者为86 % ,激素实验不敏感者 1 0 % ,HR ALL占 4 9.6 6 %。接受化疗者 4 7例 ,CR率 91 % ,进入维持治疗 1 8例 ,骨髓复发 5例 ,其余未随访治疗。 1 5例坚持治疗 ,无病生存率 (diseasefreesurvival,DFS)为 87%。结论　治疗前MIC分型和危险因素分型有助于判断预后、指导治疗 ;规范化疗是决定预后的最重要因素 ;按照 1 999年诊疗建议治疗可获得较好的CR、髓外白血病预防和DFS。Objective To analysie the clinical and laboratory data from ALL patients and the treatment results using the new protocol suggested by the Pediatric Hematology Group of China Medical Association in 1999. Methods One hundred ninety two ALL patients were enrolled in this study. MIC and clinical risk classification were done and the new chemotherapy regimen was used according to the new protocol. The data were analyzed using Microsoft Excel.Results The symptoms at diagnosis were more severe than the referred data. The infant ALL with high WBC accounted for 77.78%, but 7.68% in the older. The patients with B ALL and T ALL accounted for 59.89% and 76%% accordingly. B ALL/T ALL with myoloid antigen expression accounted for a???11.65%.aa86 % bone marrow samples showed the number and/or structures abnormalities. 10% of the patients showed bad response to predinison, but HRa2ALL accounted for 49.66% . Chemotherapy was accepted in 47cases and CR rate reached 91%.Eighteen cases en tered the maintenance stage.Five patients had relapse and DFS at this stage is 8 7%. Conclusion?tMIC and risk factor classification are important for p rognosis and treatment decision. Insistent and formal chemotherapy is the most i mportant risk factor in this study. The new protocol shows good results in CR ra te, other site ALL prevention and DFS.

关 键 词：急性淋巴细胞性白血病 儿童 临床表现 MIC分型 治疗 

分 类 号：R733.71[医药卫生—肿瘤]