AML-XH-99方案治疗婴幼儿急性髓系白血病临床总结

摘要

目的 探讨婴幼儿急性髓系白血病(AML)的临床特征及采用AML-XH-99方案的疗效.方法 1998年5月至2009年4月诊断的0～3岁AML(除外M3)26例,采用AML-XH-99方案化疗.应用SPSS13.0软件统计,采用Kaplan-Meier生存分析法进行无事件生存(EFS)分析.结果 26例患儿中M5居首(61.54％),其次为M2(26.92％).年龄＞12个月22例,＜12个月4例,7例(26.92％)起病时外周血白细胞＞50×109/L,5例(19.23％)染色体核型异常,5例(19.23％)在诱导治疗结束后48 h的骨髓涂片中幼稚细胞比例＞15％.24例(92.31％)第1疗程获完全缓解(CR),总缓解率为96.15％.5例(19.23％)骨髓复发,中位复发时间为完全持续缓解(CCR) 15.8个月.3例在强化疗后接受异体造血干细胞移植.26例中1例失访,7例死亡(5例死于疾病复发,2例死于治疗相关并发症).中位CCR时间为4.08年,7年EFS为60.72％.结论 AML-XH-99方案治疗婴幼儿急性髓系白血病缓解率高,预后良好.%Objective To analyze clinical features of acute myelogenous leukemia in children under 3 years old and treatment effect of protocol AML-XH-99. Methods From May 1998 to April 2009, 26 children under 3 years old with newly diagnosed AML (except M3) were enrolled and treated by protocol AML-XH-99. Kaplan-Meier was used to analyze EFS by SPSS13.0. Results M5 is the most common subtype (61.54%) of acute myelogenous leukemia in 26 children, and the second common subtype is M2 (26.92%). 22 children were older than 12 month, and 4 children were younger than 12 months old. 7 cases (26.92%) showed initial WBC count more than 50 x 10VL, and 5 cases showed abnormal chromosome. 5 cases showed more than 15% blasts in BM after 48hr of chemotherapy. 24 patients achieved first remission (92.31%), and complete remission (CR) was 96.15% Five patients (19.23%) relapsed in average CCR 15.8 months. Three cases received Allo-PBSCT. One of 26 patients lost follow-up, 5 died of disease relapse, and 2 died from treatment-related complications. Seven-year event free survival ( EFS) was 60.72%. Conclusions children under 3 years of age with acute myelogenous leukemia had high CR rate and better prognosis with protocol AML-XH-99.