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Clinical features of children with relapsed acute lymphoblastic leukemia treated with the CCLG-ALL2008 protocol / 中国当代儿科杂志
Chinese Journal of Contemporary Pediatrics ; (12): 321-326, 2015.
Artigo em Chinês | WPRIM | ID: wpr-346155
ABSTRACT
<p><b>OBJECTIVE</b>To study the clinical features of children with relapsed acute lymphoblastic leukemia (ALL) treated with the CCLG-ALL2008 protocol.</p><p><b>METHODS</b>The data of 591 children who were newly diagnosed with ALL and were treated with the CCLG-ALL 2008 protocol between April 2008 and June 2013 were collected, and the clinical features of 80 children with relapsed ALL were retrospectively analyzed.</p><p><b>RESULTS</b>After treatment with the CCLG-ALL2008 protocol, the recurrence rate in the standard-risk, intermediate-risk and the high-risk groups were 7.0%, 10.7% and 28.7% respectively (P<0.05). The recurrence rate in patients with TEL/AML1-positive ALL was 8.0%, and the 5-year overall survival (OS) of the relapsed patients was 37.04%. The recurrence rates in patients with MLL-positive and BCR/ABL-positive ALL were 35.0% and 24.2% respectively, and none of the relapsed patients had long-term survival. The recurrence mainly occurred at the very early stage (53%), and none of patients with recurrence at the very early stage had long-term survival. The recurrence occurred at early stage and late stage accounted for 34% and 14% respectively, and the 5-year OS rates of patients with recurrence at early stage and late stage were 11.44% and 60.00% respectively. The sites of recurrence were mainly bone marrow alone (83%), and the 5-year OS of patients with recurrence at bone marrow alone was 9.23%. The recurrence in bone marrow and outside bone marrow accounted for 11%, and the 5-year OS of patients with recurrence in both bone marrow and outside bone marrow was 25.00%. The recurrence only outside bone marrow accounted for 6%, and the 5-year OS of patients with recurrence only outside bone marrow was 100%. The recurrence rate in patients with T-cell ALL was 9.5%, and none of the relapsed patients had long-term survival. The recurrence rate in patients with B-cell ALL was 14.3%, and the 5-year OS of the relapsed patients was 15.52%.</p><p><b>CONCLUSIONS</b>After treatment with the CCLG-ALL2008 protocol, a relatively high recurrence rate is observed in children with high-risk ALL. Positive MLL and positive BCR/ABL are high-risk factors for recurrence. The recurrence rate is not significantly correlated with immunophenotype. A very low survival rate is seen in children whose recurrence have the following features at early stage, only in bone marrow, T-cell ALL, and abnormal BCR/ABL and MLL.</p>
Assuntos
Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Prognóstico / Recidiva / Protocolos de Quimioterapia Combinada Antineoplásica / Estudos Retrospectivos / Mortalidade / Usos Terapêuticos / Tratamento Farmacológico / Leucemia-Linfoma Linfoblástico de Células Precursoras Tipo de estudo: Guia de Prática Clínica / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Adolescente / Criança / Criança, pré-escolar / Feminino / Humanos / Lactente / Masculino Idioma: Chinês Revista: Chinese Journal of Contemporary Pediatrics Ano de publicação: 2015 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Prognóstico / Recidiva / Protocolos de Quimioterapia Combinada Antineoplásica / Estudos Retrospectivos / Mortalidade / Usos Terapêuticos / Tratamento Farmacológico / Leucemia-Linfoma Linfoblástico de Células Precursoras Tipo de estudo: Guia de Prática Clínica / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Adolescente / Criança / Criança, pré-escolar / Feminino / Humanos / Lactente / Masculino Idioma: Chinês Revista: Chinese Journal of Contemporary Pediatrics Ano de publicação: 2015 Tipo de documento: Artigo