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儿童急性淋巴细胞白血病(ALL)大于10岁、白细胞>50×10~9/L、T细胞型、伴各种染色体易位者对治疗效果不佳,常需在诱导缓解后增加化疗强度来改善预后,但仍有30％的病人最终复发。许多研究证实,7日治疗后病人周围血幼稚细胞≤1.0×10~9/L者比≥1.0×10~9/L者预后好。本研究应用对比的方法,对诱导缓解治疗不敏感的儿童高危型ALL在获得完全缓解后采用强化疗和标准化疗的结果进行比较,结果如下。 病人与方法 在1136例新诊断的ALL病人中有311例符合诱导缓解期治疗不敏感者(即化疗7天骨髓幼稚细胞≥25％),在病人获得CR后分为标准组156例,男89例,女67例,1～9岁50例,10～15岁73例,>16岁33例,WBC<50×10~9/L
Childhood acute lymphoblastic leukemia (ALL) is more than 10 years old, white blood cells> 50 × 10 ~ 9 / L, T cell type, with a variety of chromosomal translocations ineffective treatment, often need to increase the intensity of chemotherapy after induction of remission to improve Prognosis, but still 30% of patients eventually relapse. Many studies have confirmed that after 7 days of treatment of patients with peripheral blood naive cells ≤ 1.0 × 10 ~ 9 / L than ≥ 1.0 × 10 ~ 9 / L of good prognosis. In this study, a comparative study was conducted to compare the results of intensive chemotherapy and standard chemotherapy after achieving complete remission in children with high-risk ALL who are not susceptible to induction remission. The results are as follows. Patients and Methods Among 1136 newly diagnosed ALL patients, 311 patients were eligible for induction remission insensitivity (ie, ≥25% of bone marrow naïve cells after 7 days of chemotherapy). Patients were divided into standard group (n = 156), male 67 cases were female, 50 cases were from 1 to 9 years old, 73 cases were from 10 to 15 years old, 33 cases were> 16 years old. The WBC <50 × 10 ~ 9 / L