[Clinical Efficacy of ALL-2005 and ALL-2009 Regimen and Factors Influencing Prognosis of Newly Diagnosed ALL Patients Aged between 10-18 Years Old].

OBJECTIVE: To investigate the clinical efficacy of ALL-2005 and ALL-2009 regimen and factors influencing prognosis of newly diagnosed ALL patients aged between 10-18 years old to provide some reference for clinical diagnosis and treatment. METHODS: The clinical data including baseline clinical characteristics, induction chemotherapy effect, long-term clinical efficacy, recurrence rate and mortality of induction therapy of 119 newly diagnosed ALL patients aged between 10-18 years old from January 2008 to December 2015 were analyzed retrospectively, and the influencing factors of clinical prognosis were evaluated by univariate and multivariate analysis. RESULTS: The complete remission rate at the 5th week after induction therapy was not significantly different between ALL-2005 and ALL-2009 regimen groups (P＞0.05). The cumulative event-free survival rate and overall survival rate of 119 cases after 5-year follow-up were (63.41±3.65)% and (68.95±4.01)% respectively, and after 7-year follow-up were (61.86±3.72)% and (67.22±3.59)% respectively. The cumulative event-free survival rate and overall survival rate were not significantly different between ALL-2005 and ALL-2009 regimen groups (P＞0.05). The total recurrence rate, extramedullary recurrence rate, recurrence time and survival rate were not significantly different between ALL-2005 and ALL-2009 regimen groups (P＞0.05). The survival rate of extramedullary recurrence group was significantly higher than bone marrow recurrence group (P＜0.05). The survival rate in late term recurrence group was significantly higher than in early term recurrence group (P＜0.05). The mortality of ALL-2005 regimens was not significantly different from that of ALL-2009 regimen group (P＞0.05). Univariate analysis showed that age, sex, induction therapy, risk and fusion gene all were the factors influencing clinical prognosis (P＜0.05). Multivariate analysis by Cox regression model showed that male, non-remission after induction therapy and high risk were the independent risk factors for poor prognosis in patients (P＜0.05). The survival rate of patients with BCR-ABL+ treated with ALL-2009 regimen was significantly higher than that of patients treated with ALL-2005 regimen (P＜0.05). The event-free survival rate after 5-year follow-up of middle-risk patients treated with ALL-2005 and ALL-2009 regimens was significantly higher than that of high-risk patients (P＜0.05). The event-free survival rate after 5-year follow-up of patients with B-line ALL treated with ALL-2009 regimen was significantly higher than that of T-line ALL patients (P＜0.05). CONCLUSION: The survival rate of newly diagnosed ALL patients aged between 10-18 years old treated with ALL-2009 regimen was slightly higher than that of ALL-2005 regimen, it is more suitable for the ALL patients with BCR-ABL+, but can not reduce the recurrence rate. And the sex, the effect of induction therapy and risk closely relate with the clinical prognosis of above mentioned patients.