儿童朗格罕斯细胞组织细胞增生症34例临床分析

李丹, 李蕙, 史宏

中国当代儿科杂志 ›› 2017, Vol. 19 ›› Issue (6) : 627-631.

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中国当代儿科杂志 ›› 2017, Vol. 19 ›› Issue (6) : 627-631. DOI: 10.7499/j.issn.1008-8830.2017.06.004
论著·临床研究

儿童朗格罕斯细胞组织细胞增生症34例临床分析

  • 李丹, 李蕙, 史宏
作者信息 +

Clinical features and prognosis of Langerhans cell histiocytosis in children: an analysis of 34 cases

  • LI Dan, LI Hui, SHI Hong
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摘要

目的 探讨儿童朗格罕斯细胞组织细胞增生症(LCH)的临床特点和预后,以期提高LCH诊疗水平。方法 对34例初发LCH儿童患者进行回顾性分析。结果 34例患者中位年龄14.5个月(22 d至60个月),其中0~2岁的23例、> 2岁的11例;高危组17例,低危组17例。30例患者接受化疗,6周化疗总有效率67%(20/30),12个月总有效率87%(26/30),3年总生存(OS)率为86%±6%,3年无事件生存(EFS)率为64%±9%。高危组患者6周化疗有效率46.7%,3年OS为72%±12%,3年EFS为46%±13%,均低于低危组(86.7%、100%、82%±9%),差异均有统计学意义(P < 0.05)。高危组12个月化疗有效率(80%)与低危组(93%)的差异无统计学意义(P > 0.05);复发率和死亡率均为27%,而低危组无复发和死亡。结论 LCH总体生存率较高,但高危组6周化疗有效率低,远期预后较差。

Abstract

Objective To investigate the clinical features and prognosis of children with Langerhans cell histiocytosis (LCH). Methods A retrospective analysis was performed for the clinical data of 34 children with newly diagnosed LCH. Results The 34 children had a median age of 14.5 months (range:22 d to 60 months). Of all 34 children, 23 were aged 0-2 years and 11 were aged > 2 years. There were 17 children in the high-risk group and 17 in the low-risk group. Thirty children received chemotherapy, and the 6-week and 12-month overall response rates were 67% (20/30) and 87% (26/30), respectively. The 3-year overall survival (OS) rate was 86%±6% and the 3-year event-free survival (EFS) rate was 64%±9%. Compared with the low-risk group, the high-risk group had significantly lower 6-week chemotherapy response rate (47% vs 87%; P < 0.05), 3-year OS rate (72%±12% vs 100%; P < 0.05), and 3-year EFS rate (46%±13% vs 82%±9%; P < 0.05). There was no significant difference in the 12-month chemotherapy response rate between the high-risk and low-risk groups (80% vs 93; P > 0.05). The high-risk group had a recurrence rate of 27% and a mortality rate of 27%. There were no recurrence or deaths in the low-risk group. Conclusions Children with LCH have a high overall survival rate, but the high-risk patient has a low 6-week response rate of induction chemotherapy and poor long-term prognosis.

关键词

朗格罕斯细胞组织细胞增生症 / 治疗 / 预后 / 儿童

Key words

Langerhans cell histiocytosis / Treatment / Prognosis / Child

引用本文

导出引用
李丹, 李蕙, 史宏. 儿童朗格罕斯细胞组织细胞增生症34例临床分析[J]. 中国当代儿科杂志. 2017, 19(6): 627-631 https://doi.org/10.7499/j.issn.1008-8830.2017.06.004
LI Dan, LI Hui, SHI Hong. Clinical features and prognosis of Langerhans cell histiocytosis in children: an analysis of 34 cases[J]. Chinese Journal of Contemporary Pediatrics. 2017, 19(6): 627-631 https://doi.org/10.7499/j.issn.1008-8830.2017.06.004

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