Risk factors for recurrence of childhood acute lymphoblastic leukemia after treatment with the Chinese Children's Cancer Group ALL-2015 protocol
10.7499/j.issn.1008-8830.2401010
- VernacularTitle:CCCG-ALL-2015方案治疗儿童急性淋巴细胞白血病复发的危险因素分析
- Author:
Xia CHEN
1
;
Xiao-Ying LEI
;
Xian-Min GUAN
;
Ying DOU
;
Xian-Hao WEN
;
Yu-Xia GUO
;
Hui-Qin GAO
;
Jie YU
Author Information
1. 重庆医科大学附属儿童医院儿童血液肿瘤科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病教育部重点实验室/儿科学重庆市重点实验室,重庆 400014
- Keywords:
Acute lymphoblastic leukemia;
Chinese Children's Cancer Group ALL-2015 protocol;
Recurrence;
Risk factor;
Child
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(7):701-707
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the cumulative incidence of recurrence(CIR)in children with acute lymphoblastic leukemia(ALL)after treatment with the Chinese Children's Cancer Group ALL-2015(CCCG-ALL-2015)protocol and the risk factors for recurrence.Methods A retrospective analysis was conducted on the clinical data of 852 children who were treated with the CCCG-ALL-2015 protocol from January 2015 to December 2019.CIR was calculated,and the risk factors for the recurrence of B-lineage acute lymphoblastic leukemia(B-ALL)were analyzed.Results Among the 852 children with ALL,146(17.1%)experienced recurrence,with an 8-year CIR of 19.8%±1.6%.There was no significant difference in 8-year CIR between the B-ALL group and the acute T lymphocyte leukemia group(P>0.05).For the 146 children with recurrence,recurrence was mainly observed in the very early stage(n=62,42.5%)and the early stage(n=46,31.5%),and there were 42 children with bone marrow recurrence alone(28.8%)in the very early stage and 27 children with bone marrow recurrence alone(18.5%)in the early stage.The Cox proportional-hazards regression model analysis showed that positive MLLr fusion gene(HR=4.177,95%CI:2.086-8.364,P<0.001)and minimal residual disease≥0.01%on day 46(HR=2.013,95%CI:1.163-3.483,P=0.012)were independent risk factors for recurrence in children with B-ALL after treatment with the CCCG-ALL-2015 protocol.Conclusions There is still a relatively high recurrence rate in children with ALL after treatment with the CCCG-ALL-2015 protocol,mainly bone marrow recurrence alone in the very early stage and the early stage,and minimal residual disease≥0.01%on day 46 and positive MLLr fusion gene are closely associated with the recurrence of B-ALL.
