Clinical features and prognostic analysis of 36 children with relapsed acute lymphoblastic leukemia
10.3760/cma.j.issn.2095-428X.2018.03.009
- VernacularTitle:复发急性淋巴细胞白血病患儿36例临床特征及预后分析
- Author:
Wei TANG
1
,
2
;
Songmi WANG
;
Yaqin WANG
;
Ai ZHANG
;
Aiguo LIU
;
Liuqing ZHANG
;
Qun HU
Author Information
1. 430030武汉,华中科技大学同济医学院附属同济医院儿童血液科
2. 华中科技大学同济医学院附属武汉儿童医院/武汉市妇幼保健院血液科
- Keywords:
Acute lymphoblastic leukemia;
Recurrence;
Prognosis;
Overall survival rate;
Child
- From:
Chinese Journal of Applied Clinical Pediatrics
2018;33(3):196-199
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical features and prognostic analysis of 36 children with relapsed acute lymphoblastic leukemia(ALL)treated with the ALL 2006 protocol.Methods The data of 308 children who were new-ly diagnosed as ALL at the Department of Pediatric Hematology,Tongji Hospital,Tongji Medical College,Huazhong Uni-versity of Science Technology treated with the ALL 2006 protocol between January 2007 and December 2012 were col-lected,and the clinical features and prognosis of 36 children with relapsed ALL were retrospectively analyzed.The date included initial treatment time,age,gender,immunophenotyping,the white blood cell count,the risk classification,the chromosome,the fusion gene(29 kinds of fusion genes including MLL rearrangement,BCR/ABL,E2A/PBX1,TEL/AML1)in relapsed patients with ALL on the initial diagnosis and recurrence time,recurrence site,as well as whether to get second complete remission(CR2),follow-up time,follow-up deadline condition.Results After treatment with ALL 2006 protocol,the recurrence rate was 11.7%(36/308 cases);the 3 years overall survival rate was(38.0 ± 9.0)%.The recurrence happened almost in the very early stage,about 75.0%(27/36 cases),and the recurrence rate of the early stage and the late stage patients was 16.7%(16/36 cases)and 8.3%(3/36 cases),respectively.The re-lapsed sites were mainly in the bone marrow alone(66.7%,24/36 cases),and the extramedullary recurrence and the combination of bone marrow with extramedullary recurrence was 16.7%(6/36 cases).The 3-year OS was(16.4 ± 8.0)% and(80.0 ± 18.0)% for those relapsed in the very early stage and early stage,respectively(P=0.002).The 3-year OS of the high-risk,medium-risk relapsed patients were(21.0 ± 11.0)%,(51.9 ± 16.0)% and(64.3 ± 21.0)%(P=0.022).Conclusions After the treatment with ALL 2006 protocol,the patients with recurrence were almost at the very early stage.The relapsed sites were mainly in bone marrow alone.The factor associated with survival time of children with relapsed ALL is the relapse at the very early stage.
