Journal of Clinical Pediatrics ›› 2023, Vol. 41 ›› Issue (3): 204-209.doi: 10.12372/jcp.2023.22e0067
• Hematology and Oncology Disease • Previous Articles Next Articles
XUE Yujuan, LU Aidong, WANG Yu, JIA Yueping, ZUO Yingxi, ZHANG Leping()
Received:
2022-01-11
Online:
2023-03-15
Published:
2023-03-10
XUE Yujuan, LU Aidong, WANG Yu, JIA Yueping, ZUO Yingxi, ZHANG Leping. Clinical analysis of treatment failure in children with acute lymphoblastic leukemia[J].Journal of Clinical Pediatrics, 2023, 41(3): 204-209.
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临床特征 | 例数 | 复发时间 | 复发部位 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
极早期 | 早期 | 晚期 | χ2值 | P | 骨髓 | 中枢神经系统 | 骨髓+中枢神经系统 | 其他髓外复发 | χ2值 | P | ||
性别 | 2.25 | 0.324 | - | 0.6191) | ||||||||
男 | 73 | 33(45.2) | 27(37.0) | 13(17.8) | 58(79.5) | 5(6.8) | 8(11.0) | 2(2.7) | ||||
女 | 31 | 19(61.3) | 8(25.8) | 4(12.9) | 26(83.9) | 3(9.7) | 1(3.2) | 1(3.2) | ||||
年龄/岁 | 0.43 | 0.808 | - | 0.7911) | ||||||||
≥10 | 44 | 23(52.3) | 15(34.1) | 6(13.6) | 34(77.3) | 4(9.1) | 5(11.4) | 1(2.3) | ||||
1~10 | 60 | 29(48.3) | 20(33.3) | 11(18.3) | 50(83.3) | 4(6.7) | 4(6.7) | 2(3.3) | ||||
初诊WBC×109·L-1 | 7.53 | 0.023 | - | 0.0111) | ||||||||
≥50.0 | 33 | 23(69.7) | 7(21.2) | 3(9.1) | 23(69.7) | 3(9.1) | 7(21.2) | 0(0.0) | ||||
<50.0 | 71 | 29(40.8) | 28(39.4) | 14(19.7) | 61(85.9) | 5(7.0) | 2(2.8) | 3(4.2) | ||||
免疫分型 | - | 0.0191) | - | 0.0161) | ||||||||
B-ALL | 88 | 39(44.3) | 32(36.4) | 17(19.3) | 74(84.1) | 7(8.0) | 4(4.5) | 3(3.4) | ||||
T-ALL | 16 | 13(81.3) | 3(18.8) | 0(0.0) | 10(62.5) | 1(6.3) | 5(31.3) | 0(0.0) | ||||
融合基因 | - | 0.0221) | - | 0.5451) | ||||||||
ETV6-RUNX1+ | 6 | 0(0.0) | 4(66.7) | 2(33.3) | 5(83.3) | 0(0.0) | 0(0.0) | 1(16.7) | ||||
MLL+ | 2 | 1(50.0) | 0(0.0) | 1(50.0) | 2(100.0) | 0(0.0) | 0(0.0) | 0(0.0) | ||||
E2A-PBX1+ | 8 | 4(50.0) | 1(12.5) | 3(37.5) | 6(75.0) | 2(25.0) | 0(0.0) | 0(0.0) | ||||
BCR-ABL1+ | 9 | 7(77.8) | 2(22.2) | 0(0.0) | 7(77.8) | 1(11.1) | 1(11.1) | 0(0.0) | ||||
其他 | 79 | 40(50.6) | 28(35.4) | 11(13.9) | 64(81.0) | 5(6.3) | 8(10.1) | 2(2.5) | ||||
第15天骨髓原始 幼稚淋巴细胞/% | 1.71 | 0.426 | - | 0.8191) | ||||||||
<5.0 | 44 | 21(47.7) | 13(29.5) | 10(22.7) | 34(77.3) | 4(9.1) | 5(11.4) | 1(2.3) | ||||
≥5.0 | 46 | 27(58.7) | 13(28.3) | 6(13.0) | 39(84.8) | 3(6.5) | 3(6.5) | 1(2.2) | ||||
未检测 | 14 | 4(28.6) | 9(64.3) | 1(7.1) | 11(78.6) | 1(7.1) | 1(7.1) | 1(7.1) | ||||
第33天MRD/% | 3.35 | 0.780 | - | 0.8791) | ||||||||
≥1.0 | 21 | 11(52.4) | 7(33.3) | 3(14.3) | 17(81.0) | 1(4.8) | 2(9.5) | 1(4.8) | ||||
0.1~1.0 | 24 | 14(58.3) | 5(20.8) | 5(20.8) | 22(91.7) | 1(4.2) | 1(4.2) | 0(0.0) | ||||
0.01~0.1 | 10 | 4(40.0) | 5(50.0) | 1(10.0) | 9(90.0) | 0(0) | 1(10.0) | 0(0.0) | ||||
<0.01 | 49 | 23(46.9) | 18(36.7) | 8(16.3) | 36(73.5) | 6(12.2) | 5(10.2) | 2(4.1) | ||||
第90天MRD/% | - | 0.1291) | - | 0.3361) | ||||||||
≥0.1 | 17 | 13(76.5) | 3(17.6) | 1(5.9) | 16(94.1) | 0(0.0) | 0(0.0) | 1(5.9) | ||||
0.01~0.1 | 10 | 6(60.0) | 2(20.0) | 2(20.0) | 10(100.0) | 0(0.0) | 0(0.0) | 0(0.0) | ||||
<0.01 | 77 | 33(42.9) | 30(39.0) | 14(18.2) | 58(75.3) | 8(10.4) | 9(11.7) | 2(2.6) | ||||
复发部位 | - | 0.3211) | - | - | ||||||||
骨髓 | 84 | 45(53.6) | 25(29.8) | 14(16.7) | - | - | - | |||||
中枢神经系统 | 8 | 3(37.5) | 3(37.5) | 2(25) | - | - | - | |||||
骨髓+中枢神经系统 | 9 | 4(44.4) | 4(44.4) | 1(11.1) | - | - | - | |||||
其他髓外复发 | 3 | 0(0.0) | 3(100.0) | 0(0.0) | ||||||||
危险度 | - | 0.0291) | - | 0.0531) | ||||||||
标危 | 11 | 2(18.2) | 7(63.6) | 2(18.2) | 8(72.7) | 0(0.0) | 1(9.1) | 2(18.2) | ||||
中危 | 52 | 23(44.2) | 18(34.6) | 11(21.2) | 41(78.8) | 7(13.5) | 4(7.7) | 0(0.0) | ||||
高危 | 41 | 27(65.9) | 10(24.4) | 4(9.8) | 35(85.4) | 1(2.4) | 4(9.8) | 1(2.4) |
"
预后因素 | 失败例数 | 3年OS率/% | χ2值 | P | 3年TFS率/% | χ2值 | P |
---|---|---|---|---|---|---|---|
性别 | 0.25 | 0.621 | 1.91 | 0.167 | |||
男 | 82 | 87.2±1.7 | 81.7±2.0 | ||||
女 | 42 | 87.0±2.1 | 84.9±2.3 | ||||
年龄/岁 | 15.00 | 0.001 | 11.82 | 0.003 | |||
≥10 | 54 | 79.3±2.9 | 75.3±3.1 | ||||
1~10 | 70 | 90.6±1.4 | 86.3±1.6 | ||||
初诊WBC×109·L-1 | 10.41 | 0.001 | 10.60 | 0.001 | |||
≥50.0 | 39 | 77.9±3.6 | 73.6±3.8 | ||||
<50.0 | 85 | 89.7±1.4 | 85.5±1.6 | ||||
免疫分型 | 12.98 | <0.001 | 7.04 | 0.008 | |||
T-ALL | 23 | 72.8±5.1 | 70.3±5.2 | ||||
B-ALL | 101 | 89.1±1.3 | 84.7±1.5 | ||||
融合基因 | 38.42 | <0.001 | 38.85 | <0.001 | |||
ETV6/RUNX1+ | 6 | 97.8±1.6 | 95.7±2.1 | ||||
MLL+ | 3 | 91.7±5.6 | 91.7±5.6 | ||||
E2A/PBX1+ | 11 | 89.7±4.9 | 79.5±6.5 | ||||
BCR/ABL1+ | 13 | 77.7±5.9 | 74.0±6.2 | ||||
其他 | 91 | 85.6±1.8 | 81.1±2.0 | ||||
伴髓外浸润 | 7.42 | 0.006 | 3.69 | 0.055 | |||
是 | 13 | 74.4±6.7 | 74.4±6.7 | ||||
否 | 111 | 88.0±1.4 | 83.6±1.5 | ||||
第15天骨髓原始幼稚淋巴细胞/%1) | 23.63 | <0.001 | 32.23 | <0.001 | |||
≥5.0 | 55 | 78.2±3.2 | 70.5±3.5 | ||||
<5.0 | 52 | 92.0±1.4 | 89.4±1.6 | ||||
第33天MRD/%2) | 80.00 | <0.001 | 76.43 | <0.001 | |||
≥1.0 | 27 | 55.9±7.0 | 52.0±7.1 | ||||
0.1~1.0 | 25 | 77.6±5.1 | 70.1±5.6 | ||||
0.01~0.1 | 10 | 89.3±3.8 | 87.1±4.0 | ||||
<0.01 | 59 | 92.3±1.3 | 88.3±1.5 | ||||
90天MRD/%3) | 47.29 | <0.001 | 55.68 | <0.001 | |||
≥0.1 | 18 | 53.1±8.8 | 46.9±8.8 | ||||
0.01~0.1 | 10 | 76.0±8.5 | 68.0±9.3 | ||||
<0.01 | 92 | 90.1±1.3 | 86.2±1.5 | ||||
危险度分层 | 53.46 | <0.001 | 47.01 | <0.001 | |||
标危 | 13 | 97.0±1.3 | 93.6±1.9 | ||||
中危 | 60 | 88.7±1.8 | 84.0±2.1 | ||||
高危 | 51 | 70.8±3.8 | 66.7±4.0 |
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