在资源有限的环境下,儿童急性淋巴细胞白血病的临床实验室特征和结局:一项来自南埃及的研究

A. Ali, Amira M. El-Hefedy, D. Sayed, A. Osman
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引用次数: 1

摘要

背景:儿童急性淋巴细胞白血病(ALL)的治疗取得了显著进展,高收入国家的存活率达到80%以上。在埃及,ALL的治疗结果一直不太好。目的:评估Sohag癌症中心住院患者的临床实验室特征,并评估其结果和影响预后的因素。Jude儿童研究医院(SJCRH)。结果:52%为男性,中位年龄为6岁。58.2%为HR,69.6%为前体B-ALL,39.2%为总白细胞计数(≥50x109/L),11.3%为中枢神经系统白血病。87.3%的患者获得完全缓解。就治疗结果而言,诱导失败率为5.1%,复发率为24.1%,CR死亡率为7.2%,持续完全缓解率为59.5%。中位随访时间为42个月,4年OS、EFS和DFS分别为64.1±5.6、57±5.7和63.3±5.8%。TLC和骨髓抽吸是影响EFS的唯一重要预后因素。结论:SJCRH的改良TXIIIB在改善我们中心的ALL结果方面是有效的,然而,存活率远低于国际报道的结果,只有最初的TLC和诱导后的反应对EFS和DFS有显著影响。
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Clinicolaboratory Characteristics and Outcome of Pediatric Acute Lymphoblastic Leukemia in a Resource-Limited Setting: A Study from South Egypt
Background: Remarkable progress has been made in the treatment of pediatric acute lymphoblastic leukemia (ALL), with survival rates reaching > 80% in high-income countries. In Egypt, the outcome of treatment of ALL has been less favorable. Aim: To evaluate the clinicolaboratory characteristics in patients admitted at Sohag Cancer Center and to assess the outcome and the prognostic factors affecting it. Methods: This retrospective study included 79 pediatric ALL patients, from January 2010 to December 2014, who were treated according to modified Total therapy study XIIIB high-risk ALL of St. Jude Children's Research Hospital (SJCRH). Results: 52% were males with a median age of 6 years. 58.2% were stratified as HR, 69.6% had precursor B-ALL, 39.2% presented with t otal leucocytic count (TLC) (≥ 50x109/L), and 11.3% had CNS leukemia. Complete remission (CR) was achieved in 87.3%. Regarding treatment outcome, induction failure was reported in 5.1%, relapse in 24.1%, deaths in CR in 7.2%, and continuous complete remission in 59.5%. The median follow-up was 42 months, 4 years OS, EFS, and DFS were 64.1 ± 5.6, 57 ± 5.7, and 63.3 ± 5.8% respectively. TLC and bone marrow aspirate postinduction were the only significant prognostic factors affecting EFS. Conclusions: The modified TXIIIB of SJCRH was effective in improving ALL outcomes in our center, however, survival rates were much lower than internationally reported results with only initial TLC and response postinduction having a significant effect on EFS and DFS.
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