10岁以上儿童青少年急性淋巴细胞白血病的临床特点及预后分析

发布时间：2019-04-03 07:32

【摘要】：目的研究10岁以上儿童青少年初诊急性淋巴细胞白血病(ALL)患儿的临床特点及预后。方法对86例10岁以上ALL患儿(B-ALL 62例,T-ALL 24例)的临床特点、治疗疗效及预后因素进行回顾性分析,采用Kaplan-Meier分析评估患儿无事件生存率(EFS)和总生存率(OS),COX回归模型评估EFS、OS的影响因素。结果 86例患儿中,中危组和高危组患儿分别为62例和24例。首诊表现为肝肿大的53例(62%),脾肿大50例(58%),淋巴结肿大46例(54%)。初诊时外周血WBC≥50×109/L者29例(34%)。78例进行了染色体核型分析,21例(27%)染色体数目异常,其中15例为超二倍体(19%)、4例(5%)为亚二倍体,2例(3%)为假二倍体;11例(14%)染色体结构异常,其中Ph染色体阳性1例,t(1;19)1例。TEL-AML1融合基因3例(4%),E2A-PBX1融合基因3例(4%),BCR-ABL融合基因6例(7%),SIL-TAL1融合基因4例(5%)。1疗程完全缓解率为99%(85/86)。5年EFS率、OS率分别为64%±6%和75%±5%。中危组的5年EFS率、OS率均高于高危组(P0.05)。B-ALL患儿5年EFS率优于T-ALL组(P0.05)。COX多因素回归分析显示,初诊时白细胞计数、诱导缓解末微小残留病是EFS、OS的独立影响因素。结论 10岁以上ALL患儿具有不利预后的临床特征,初诊时白细胞计数、诱导缓解末MRD是决定远期疗效的重要因素。
[Abstract]:Objective to study the clinical characteristics and prognosis of children over 10 years old with newly diagnosed acute lymphoblastic leukemia (ALL). Methods the clinical features, therapeutic efficacy and prognostic factors of 86 children over 10 years old with ALL (B-ALL 62, T-ALL 24) were retrospectively analyzed. The event-free survival rate (EFS) and total survival rate (OS),) were evaluated by Kaplan-Meier analysis. COX regression model was used to evaluate the influencing factors of EFS,OS. Results among the 86 cases, 62 cases in the middle-risk group and 24 cases in the high-risk group were in the middle-risk group and in the high-risk group. The first diagnosis was hepatomegaly in 53 cases (62%), splenomegaly in 50 cases (58%) and lymphadenopathy in 46 cases (54%). At the time of initial diagnosis, WBC 鈮，

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