| 摘要: |
| 目的评价按照中国成人急性淋巴细胞白血病（ALL）协作组制定的成人ALL序贯化疗整体方案（CALLG2008）治疗60岁以下初发成人B细胞ALL（B-ALL）的疗效，并比较分析不同危险因素分层亚组之间的治疗结果，观察异基因造血干细胞移植（Allo-SCT）对患者生存期的影响。方法对2009年3月至2014年8月接受CALLG2008方案治疗的60岁以下初发成人B-ALL患者39例进行随访，分析接受该方案诱导治疗后患者的完全缓解（CR）率、毒性反应和总生存（OS）、无事件生存（EFS）情况。结果39例患者中3例早期死亡，其余36例中33例获CR，1个疗程CR率为91.7%。随访至2014年8月1日，中位随访时间25个月；预计3年OS率为53.7%，EFS率为45.6%。预后因素分析提示，患者年龄＞35岁以及初诊时白细胞计数＞30×109/L是预后的不良因素。Allo-SCT能显著延长患者尤其是高危组患者的OS期及EFS期。主要不良反应为血液学毒性反应，诱导治疗中有88.9%（32/36）出现Ⅳ级血液学毒性反应。结论CALLG2008方案治疗60岁以下成人B-ALL有较高CR率及长期生存。患者年龄和初诊时白细胞计数是影响预后的重要因素。Allo-SCT可明显延长OS期。 |
| 关键词: 急性淋巴细胞白血病 化疗 预后 Ph 染色体 |
| DOI： |
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| 基金项目:浙江省卫生厅科研基金；浙江省中医药管理局科研基金；浙江省重点科技创新团队 |
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| Efficacy and safety of CALLG2008 protocol in treatment of patients with incipient acute B lymphoblastic leukemia |
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ZHANG Kaifeng, WEI Juying, HUANG Jian, YU Wenjuan, MENG Haitao, MAI Wenyuan, TONG Hongyan, JIN Jie, QIAN Wenbin
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the First Affiliated Hospital，Zhejiang University School of Medicine
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| Abstract: |
| Objective To evaluate the efficacy and safety of CALLG2008 protocol, which was suggested by China
Collaborative Group of Acute Lymphoblastic Leukemia, in patients with incipient acute B lymphoblastic leukemia. Methods The clinical data of 39 patients aged ＜60 years with acute B lymphoblastic leukemia (B-ALL) receiving CALLG2008 protocol were reviewed. The event-free survival (EFS) , overall survival (OS) rate and adverse events were assessed. Results Thirty-three (91.7%) patients showed complete remission. Median OS was 25 months. Three years estimated OS and EFS rates were 53.7% and 45.6%, respectively (median follow-up, 25 months). Age＞35 years and white blood cell count＞30×109/L at diagnosis were associated with shorter OS and EFS. Allogeneic hematopoietic stem cell transplantation significantly prolonged the OS and EFS, especially in patients with high risks. Conclusion These data indicate that CALLG2008 protocol for ALL exhibits benefit in the improvement of outcomes of adult B-ALL patients. |
| Key words: Acute lymphoblastic leukemia Chemotherapy Prognosis Ph chromosome |
