[Prognostic factors in children with acute T-lymphoblastic leukemia: a single-center clinical study of the CCCG-ALL-2015 protocol].

Q3 Medicine 中国当代儿科杂志 Pub Date : 2024-10-15 DOI:10.7499/j.issn.1008-8830.2402079

Wen-Feng Fu, Yong-Jun Fang

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Abstract

Objectives: To explore the clinical characteristics of children with acute T-lymphoblastic leukemia (T-ALL) and analyze their relationship with prognosis.

Methods: A retrospective analysis was conducted on the clinical data and follow-up results of 50 children with T-ALL who were treated using the CCCG-ALL-2015 protocol at the Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University from November 2015 to December 2019. Kaplan-Meier survival analysis and Cox regression analysis were employed to identify factors affecting prognosis.

Results: Among the 50 T-ALL patients, there were 7 cases of relapse. There was no statistically significant difference in the baseline clinical data between the relapse group and the non-relapse group (P>0.05). However, the positive rate of minimal residual disease (MRD) (≥0.01%) on day 46 after induction remission therapy in the relapse group was significantly higher than that in the non-relapse group (P=0.037). The 5-year overall survival rate for the 50 patients was (87±5)%, and the 5-year event-free survival rate was (86±5)%. Multivariate Cox regression analysis indicated that the MRD level on day 46 after induction remission therapy was an independent prognostic factor (HR=0.104, 95%CI: 0.015-0.740, P=0.024).

Conclusions: MRD is of significant importance for the prognosis of T-ALL children. Personalized treatment should be provided based on MRD levels to prevent relapse and improve prognosis in these patients.

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[急性T淋巴细胞白血病患儿的预后因素：CCCG-ALL-2015方案的单中心临床研究]。

目的探讨急性T淋巴细胞白血病（T-ALL）患儿的临床特征，并分析其与预后的关系：回顾性分析2015年11月至2019年12月南京医科大学附属儿童医院血液肿瘤科采用CCCG-ALL-2015方案治疗的50例T-ALL患儿的临床资料和随访结果。采用Kaplan-Meier生存分析和Cox回归分析确定影响预后的因素：在50例T-ALL患者中，有7例复发。复发组与未复发组的基线临床数据差异无统计学意义（P>0.05）。然而，复发组诱导缓解治疗后第46天最小残留病（MRD）阳性率（≥0.01%）明显高于非复发组（P=0.037）。50例患者的5年总生存率为（87±5）%，5年无事件生存率为（86±5）%。多变量考克斯回归分析表明，诱导缓解治疗后第46天的MRD水平是一个独立的预后因素（HR=0.104，95%CI：0.015-0.740，P=0.024）：结论：MRD对T-ALL儿童的预后具有重要意义。结论：MRD对T-ALL患儿的预后有重要影响，应根据MRD水平提供个性化治疗，以防止复发并改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

中国当代儿科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

1.50

自引率

0.00%

发文量

5006

期刊介绍： The Chinese Journal of Contemporary Pediatrics (CJCP) is a peer-reviewed open access periodical in the field of pediatrics that is sponsored by the Central South University/Xiangya Hospital of Central South University and under the auspices of the Ministry of Education of China. It is cited as a source in the scientific and technological papers of Chinese journals, the Chinese Science Citation Database (CSCD), and is one of the core Chinese periodicals in the Peking University Library. CJCP has been indexed by MEDLINE/PubMed/PMC of the American National Library, American Chemical Abstracts (CA), Holland Medical Abstracts (EM), Western Pacific Region Index Medicus (WPRIM), Scopus and EBSCO. It is a monthly periodical published on the 15th of every month, and is distributed both at home and overseas. The Chinese series publication number is CN 43-1301/R；ISSN 1008-8830. The tenet of CJCP is to “reflect the latest advances and be open to the world”. The periodical reports the most recent advances in the contemporary pediatric field. The majority of the readership is pediatric doctors and researchers.