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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

  • 姜健 ,
  • 仲任 ,
  • 卢愿 ,
  • 汤静燕 ,
  • 袁晓军 ,
  • 王宁玲 ,
  • 徐慧娟 ,
  • 李学荣 ,
  • 蒋慧 ,
  • 孙立荣
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  • 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

  网络出版日期: 2014-11-15

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

  • JIANG Jian ,
  • ZHONG Ren ,
  • LU Yuan ,
  • TANG Jingyan ,
  • YUAN Xiaojun ,
  • WANG Ningling ,
  • XU Huijuan ,
  • LI Xuerong ,
  • JIANG Hui ,
  • SUN Lirong
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  • 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 date: 2014-11-15

  Online 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。

本文引用格式

姜健 , 仲任 , 卢愿 , 汤静燕 , 袁晓军 , 王宁玲 , 徐慧娟 , 李学荣 , 蒋慧 , 孙立荣 . 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[J]. 临床儿科杂志, 2014 , 32(11) : 1028 . DOI: 10.3969 j.issn.1000-3606.2014.11.008

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.
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