Objective To analyze and assess the risk factors affecting acute lymphoblastic leukemia in children, then to improve survival and long-term quality of life using individual treatment programs for children. Method This article used retrospective study. 200 children with newly diagnosed acute lymphoblastic leukemia admitted into our hospital from May, 2012 to March, 2016 were selected as research objects. The clinical data were collected; and the association of various prognostic factors and changes of risk stratification were analyzed. Results The induction therapy complete remission rate of the 200 cases of acute lymphoblastic leukemia was 95.5％ after the stratification of risk and related treatment. WBC ≥ 50 × 109/L at initial treatment, prednisone-induced insensitivity, age > 9 years old and < 1 year old, bone marrow immature cells > 5％ on the 33rd day of induction, BCR/ABL and MLL/AF4 fusion gene positive were the risk factors increasing recurrence and mortality. Conclusion The age at initial treatment, peripheral white blood cell count, fusion gene, chromosomal abnormalities karyotype and translocation, CNS status, the treatment of morphological reactions, and minimal residual lesions are the long-term risk factors affecting the prognosis of children with acute lymphoblastic leukemia.%目的 分析研究影响儿童急性淋巴细胞白血病的危险因素,并进行严格评估,对患儿采用个体化治疗方案,从而提高生存率及改善长期生活质量.方法 本文采用回顾性研究,选取2012年5月至2016年3月入住本院血液肿瘤科的200例初治急性淋巴细胞白血病患儿为研究对象,收集临床资料,分析各种预后因素的相关性及危险度的变化.结果 经危险度分层及相关治疗,200例急性淋巴细胞白血病患儿诱导治疗完全缓解率达95.5％.初治时WBC≥50×109/L,泼尼松诱导不敏感,年龄>9岁及<1岁,诱导治疗第33天骨髓中幼稚细胞>5％,BCR/ABL及MLL/AF4融合基因阳性者均增加复发率及病死率.结论 患儿初治时年龄、外周血白细胞计数、融合基因、染色体异常核型及易位、中枢神经系统状态、治疗形态学反应、微小残留病灶等均是影响患儿长期生存的预后危险因素.
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