临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (11): 1028-.doi: 10.3969 j.issn.1000-3606.2014.11.008

• 综合报道 • 上一篇    下一篇

SCMC-ALL-2005 方案治疗儿童B 细胞型急性淋巴细胞白血病疗效观察

徐慧娟1,姜健1,仲任1,李学荣1,卢愿1,汤静燕2,蒋慧3,袁晓军4,王宁玲5,孙立荣1   

  1. 1. 青岛大学附属医院血液儿科( 山东青岛 266003);2. 上海交通大学医学院附属上海儿童医学中心血液/ 肿瘤科( 上海 200127);3. 上海交通大学附属上海市儿童医院血液科( 上海 200040);4. 上海交通大学医学院附属新华医院儿童血液/ 肿瘤科( 上海 200092);5. 安徽医科大学附属第二医院儿科( 安徽合肥 230601)
  • 收稿日期:2014-11-15 出版日期:2014-11-15 发布日期:2014-11-15
  • 通讯作者: 孙立荣 E-mail:Sunlr@vip.sina.com

Outcome of childhood B-cell acute lymphoblastic leukemia treated with SCMC-ALL-2005 protocol

XU Huijuan1, JIANG Jian1, ZHONG Ren1, LI Xuerong1, LU Yuan1, TANG Jingyan2, JIANG Hui3, YUAN Xiaojun4, WANG Ningling5, SUN Lirong1     

  1. 1.Department of Pediatrics, The Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, Shandong, China; 2.Department of Hematology/Oncology, Shanghai Children’s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200127, China; 3.Department of Hematology, Shanghai Children’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200040, China; 4.Department of Hematology/Oncology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China; 5.Department of Pediatrics, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China
  • Received:2014-11-15 Online:2014-11-15 Published:2014-11-15

摘要: 目的 评估上海儿童医学中心-急性淋巴细胞性白血病-2005(SCMC-ALL-2005)治疗方案治疗儿童B细胞型ALL的疗效。方法 按照SCMC-ALL-2005方案,5家医院对2005年5月1日至2009年4月30日新发B细胞型ALL患儿进行诊断、治疗和随访。结果 研究期间共收治B细胞型ALL患儿601例,539例(89.68%)随访至2011年9月30日。601例患儿中,低危284例、中危231例、高危86例,均按照诊疗建议治疗。诱导期间缓解率为98.84%(7例未缓解),第一次事件发生时的中位时间为35个月(2.94年),至随访终止日的539例随访病例中共完成治疗403例(74.77%);低危组完成治疗223例(86.43%),中危组150例(73.17%),高危组30例(39.47%),三组间的差异有统计学意义(P=0.001)。采用Kaplan-Meier方法评估患儿随访3年的总生存率为(83.3±1.8)%,3年无事件生存(EFS)率为(79.2±1.9)%;随访5年总生存率为(79.5±3.3)%,5年EFS率为(70.9±3.7)%。低、中、高危三组间3年及5年EFS率差异有统计学意义(P均<0.05)。结论 SCMC-ALL-2005方案治疗儿童B细胞型ALL的疗效比较满意,多中心协作有助于儿童白血病的规范化治疗。

Abstract: Objective To analyze the outcome of childhood B-cell acute lymphoblastic leukemia treated(ALL) with SCMC-ALL-2005 protocol. Methods Newly diagnosed B-cell ALL from May 1, 2005 to April 30, 2009 in five hospitals were treated and followed up according to SCMC-ALL-2005 protocol. Results A total of 601 cases with newly diagnosed B-cell ALL were enrolled. Among them, 539 cases (89.68%) were followed up until September 30, 2011. In 601 patients, there were 284 low-risk cases (LR group), 231 moderate-risk cases (MR group) and 86 high-risk cases (HR group) which were treated with SCMC-ALL-2005 protocol. The total complete remission rate during the period of induction was 98.84% and 7 cases did not achieve complete remission. The median time of the first event occurring was 35 months (2.94 years). Among 539 cases completing follow-up, 403 cases (74.77%) completed treatment including 223 cases (86.43%) in LR group, 150 cases (73.17%) in MR group and 30 cases (39.47%) in HR group. The rate of cases completing treatment was significantly different among three groups (P=0.001). The completion rate was highest in LR group and lowest in HR group. The 3-year overall survival (OS) rate was (83.3±1.8) %, and the 3-year EFS (event-free survival) rate was (79.2±1.9) % using a Kaplan-Meier method. The 5-year OS rate was (79.5±3.3) %, and the 5-year EFS rate was (70.9±3.7) %. There were significant differences in 3-year EFS rate and 5-year EFS rate among three groups (P<0.05). Conclusions Childhood B-ALL treated with SCMC-ALL-2005 protocol achieved a better therapeutic effect and prognosis. The multi-center collaborative research is useful for the standard treatment of ALL.