SCMC APL-2010方案治疗44例儿童急性早幼粒细胞白血病的临床总结

doi:10.7499/j.issn.1008-8830.2019.11.004

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摘要

目的评价SCMC APL-2010方案治疗儿童急性早幼粒细胞白血病（APL）的疗效。方法收集2010年4月至2016年7月采用SCMC APL-2010方案治疗的44例APL患儿的临床资料，采用Kaplan-Meier生存分析评估患儿的无事件生存（EFS）率和总生存（OS）率。结果 44例APL患儿中，42例（95%）经1个疗程达完全缓解（CR），1例经2个疗程达CR，总CR率为98%，9年EFS率为96%±3%，OS率为97.7%±2.2%。不良事件中，发生感染41例（93%），粒细胞减少29例（66%），分化综合征12例（27%，其中死亡1例），肝功能异常16例（36%），胃肠道不良反应12例（27%），QT间期延长7例（16%），睾丸炎1例（2%），无第二肿瘤发生。结论 SCMC APL-2010方案治疗儿童APL预后好，可获得长期生存，但治疗相关感染较多。

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	王卓
	沈树红
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	潘慈
	汤静燕
	顾龙君
	陈静

关键词 ：急性早幼粒细胞白血病, SCMC APL-2010方案, 生存率, 儿童

Abstract：Objective To study the clinical effect of the SCMC APL-2010 regimen in the treatment of acute promyelocytic leukemia (APL) in children. Methods A retrospective analysis was performed for the clinical data of 44 children with APL who received treatment with the SCMC APL-2010 regimen between April 2010 and July 2016. The Kaplan-Meier survival analysis was used to evaluate event-free survival (EFS) rate and overall survival (OS) rate. Results Of the 44 children with APL, 42 (95%) achieved a complete remission (CR) after one course of treatment and 1 achieved CR after two courses of treatment, with an overall CR rate of 98%. The 9-year EFS and OS rates were 96%±3% and 97.7%±2.2% respectively. As for adverse events, 41 (93%) had infection, 29 (66%) had granulocyte reduction, 12 (27%, 1 died) had differentiation syndrome, 16 (36%) had liver dysfunction, 12 (27%) had adverse gastrointestinal reactions, and 7 (16%) had QT prolongation, 1 (2%) had orchitis, and no secondary neoplasm was observed. Conclusions Children with APL receiving the SCMC APL-2010 regimen have a good prognosis and can achieve a long-term survival, while treatment-related infection is commonly seen.

Key words： Acute promyelocytic leukemia SCMC APL-2010 regimen Survival rate Child

收稿日期: 2019-05-27

基金资助:浦东新区科技发展基金民生科研专项资金医疗卫生项目（PKJ2016-Y36）；国家自然科学基金（81200374）。

通讯作者: 陈静,女,副主任医师。Email:chen-jing@scmc.com.cn。 E-mail: chen-jing@scmc.com.cn

作者简介: 王卓,男,博士,主治医师。

引用本文:

王卓,沈树红,汤燕静等. SCMC APL-2010方案治疗44例儿童急性早幼粒细胞白血病的临床总结[J]. 中国当代儿科杂志, 2019, 21(11): 1073-1078.

WANG Zhuo,SHEN Shu-Hong,TANG Yan-Jing et al. Clinical effect of the SCMC APL-2010 regimen in treatment of acute promyelocytic leukemia in children: an analysis of 44 cases[J]. CJCP, 2019, 21(11): 1073-1078.

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http://www.zgddek.com/CN/10.7499/j.issn.1008-8830.2019.11.004 或 http://www.zgddek.com/CN/Y2019/V21/I11/1073

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