
AML-XH-99-M3 方案治疗33例儿童急性早幼粒细胞白血病临床总结
陈静, 顾龙君, 汤静燕, 薛惠良, 潘慈, 叶启东, 江华, 董璐, 周敏, 王耀平
中国当代儿科杂志 ›› 2008, Vol. 10 ›› Issue (3) : 329-332.
AML-XH-99-M3 方案治疗33例儿童急性早幼粒细胞白血病临床总结
Effectiveness of the AML-XH-99-M3 protocol for treatment of acute promyelocytic leukemia in children
目的:评价AML-XH-99-M3方案治疗儿童急性早幼粒细胞白血病(M3)疗效。方法:33例M3患儿接受AML-XH-99-M3方案治疗,应用Kaplan-Meier方法进行生存分析,评估患儿的无事生存期(EFS)、无疾病生存期(DFS)及总生存期(OS),所有数据采用SPSS13.0软件统计。结果:33例患儿30例(90.9%)一个疗程达完全缓解(CR),余3例二个疗程CR,总CR率为100%,复发6例(18.2%),平均复发时间为29(16~38)个月,死亡2例(6.1%),7年EFS和DFS均为(73.4±9.4)%,总OS为(91.2±6.0)%,维持治疗中间歇加用全反式维甲酸(ATRA)和无ATRA两组EFS差异有统计学意义,分别为(88.9±10.5)%和(62.5±13.6)%(P<0.05)。结论:AML-XH-99-M3方案治疗儿童M3获得了很好的CR率,具有较高的EFS、DFS和OS,维持治疗中加用ATRA可明显降低复发率、提高EFS。
OBJECTIVE: To evaluate the effectiveness of AML-XH-99-M3 protocol for treatment of acute promyelocytic leukemia (APL) in children.METHODS: Thirty-three children with APL received AML-XH-99-M3 protocol treatment. The event-free survival (EFS), disease-free survival (DFS), and overall survival (OS) were evaluated by the Kaplan-Meier medthod with SPSS13.0 software.RESULTS: Thirty patients (90.9%) achieved a complete remission (CR) after one course of treatment. The total CR rate was 100%. Six patients (18.2%) relapsed in an average of 29.17 months (16-38 months). Two patients (6.1%) died. The 7-year EFS and DFS in the 30 patients were 73.4±9.4%. The overall survival rate was 91.2±6.0%. The difference of EFS was observed in patients receiving intermittent all-trans-retinoic acid (ATRA) administration or not in the maintenance therapy (88.9±10.5% vs 62.5±13.6%) (P<0.05).CONCLUSIONS: The AML-XH-99-M3 protocol for the treatment of APL produced a higher CR rate and higher EFS, DFS and OS rates in children. Intermittent administration of ATRA in the maintenance therapy can improve EFS rate.
急性早幼粒细胞白血病 / 治疗方案 / 疗效 / 儿童
Acute promyelocytic leukemia / Treatment protocol / Effectiveness / Child