血液肿瘤疾病专栏

两种诱导治疗方案治疗儿童急性髓系白血病效果观察

  • 翟钦 ,
  •  何海龙 ,
  •  卢俊 ,
  •  肖佩芳 ,
  •  丁飞 ,
  •  孙伊娜 ,
  •  范俊杰 ,
  •  胡绍燕 ,
  •  王易 ,
  •  吕慧
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  • 1.南京医科大学附属苏州医院  苏州科技城医院(江苏苏州 215000)苏州大学附属儿童医院 血液肿瘤科(江苏苏州 215000)

收稿日期: 2018-05-15

  网络出版日期: 2018-05-15

基金资助

国家自然科学基金项目(No. 81170513,81370627);江苏省科技厅临床医学科技专项 江苏省临床医学研究中心项目 (No. BL2012005);江苏省卫生厅面上项目(No. H201212);苏州市儿童白血病重点实验室(No. LCZX201507);苏州 市临床重点专病(No. SZS201615)

Comparison of two kinds of induction therapy in childhood acute myeloid leukemia

  •  ZHAI Qin ,
  • HE Hailong ,
  • LU Jun ,
  • XIAO Peifang ,
  • DING Fei ,
  • SUN Yina ,
  • FAN Junjie ,
  • HU Shaoyan ,
  • WANG Yi ,
  • LYU Hui
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  • 1.Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215000, Jiangsu, China; 2.Hematology and Oncology Department,Suzhou Children’s Hospital Affiliated to Soochow University, Suzhou 215000, Jiangsu, China

Received date: 2018-05-15

  Online published: 2018-05-15

摘要

目的 评价两种诱导缓解治疗方案(3+7方案和3+10方案)治疗儿童急性髓系白血病(AML)的疗效。方法 回顾分析2010年1月至2015年1月接受化疗的AML患儿100例,按入院时间分别接受3+7方案(AML-06方案, A组)和 3+10方案(改良AML方案, B组),比较两组的疗效及不良反应。结果 A组56例,男31例、女25例,中位年龄8.2岁(全 距1.0~13.0岁),FAB分型,M1型5例、M2型25例、M4型11例、M5型10例、M6型2例、M7型3例; B组44例,男26 例、女18例,中位年龄9.3岁(全距1.4~12.5),FAB分型:M2型17例、M4型14例、M5型9例、M6型2例、M7型2例。 A组首疗诱导完全缓解(CR)率为48.2%低于B组首疗完全缓解率(70.4%),两组间差异有统计学意义(P<0.05)。B组 的骨髓抑制期较A组长,诱导化疗后中性粒细胞数、血红蛋白、血小板恢复时间也均较A组长,差异均有统计学意义(P均 <0.05)。A组化疗相关死亡率1.8%, B组为2.3%,差异无统计学意义(P>0.05)。A组3年总生存率为75.0%, B组总生存 率为86.4%,差异有统计学意义(P<0.05)。 结论 两种治疗方案对AML均有效,3+10方案完全缓解率高,不良反应无明 显增加。

本文引用格式

翟钦 ,  何海龙 ,  卢俊 ,  肖佩芳 ,  丁飞 ,  孙伊娜 ,  范俊杰 ,  胡绍燕 ,  王易 ,  吕慧 . 两种诱导治疗方案治疗儿童急性髓系白血病效果观察[J]. 临床儿科杂志, 2018 , 36(5) : 321 . DOI: 10.3969/j.issn.1000-3606.2018.05.001

Abstract

Objective To compare the efficacy and safety of induction therapy in 3+7 protocol and 3+10 protocol in children with acute myeloid leukemia (AML). Methods Two protocols were carried out in our hospital during January 2010 to January 2015, namely 3+7 protocol(AML-06,A group) and 3+10 protocol (modified AML protocol, B group). A total of 56 cases aged from 1 year-old to 13 year-old were enrolled in A group with male to female ratio at 31:25. Five of them were classified as FAB M1, 25 as M2, 11 as M4, 10 as M5, 2 as M6 and 3 as M7. Another 44 cases aged from 1 year to 12 years were enrolled in B group with a male to female ratio at 26:18, and 17 cases were classified as FAB M2, 14 as M4, 9 as M5, 2 as M6, and 2 as M7. Efficacy and adverse events were compared between the two groups. Results The complete remission rate (CR) of B group was 70.4%, while CR in A group was 48.2%. Considering the CR, 3+10 protocol showed higher efficacy than 3+7 protocol (P< 0.05). The major adverse event was bone marrow suppression. Treatment-related mortality (TRD) in A group was 1.8%, which was lower than that in B group (2.3%). The overall survival rate in A group was 75.0%, which was lower than that in B group (86.4%, P< 0.05). Conclusions The induction therapy of 3+10 protocol and 3+7 protocol showed effectiveness for AML treatment. The 3+10 protocol showed a higher CR than 3+7 protocol with no TRD increase, indicating that the 3+10 protocol should be recommended for AML treatment in children.
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