Long-term outcome of childhood acute myeloid leukemia: A 10-year retrospective cohort study
Long-term outcome of childhood acute myeloid leukemia: A 10-year retrospective cohort study
复制标题
DOI：
10.4081/pr.2020.8486
复制
发表时间：
2020-01-01
影响因子：
1.1
通讯作者：
Hiep, Pham Nhu
中科院分区：
文献类型：
--
作者：
Hao, Tran Kiem;Ha, Chau Van;Hiep, Pham Nhu
儿童急性髓系白血病(AML)是一种严重的疾病。如果治疗得当，长期存活率通常在50%以上。2010年前，所有AML患者均在本院死亡，遗弃率超过50%。本研究旨在探讨顺化中心医院自2010年1月至2019年12月收治的98例急性髓系白血病患儿的远期预后。诊断依据形态FAB标准、细胞化学和免疫表型。采用改良的AML 7-3方案治疗。向患者/家属提供社会支持。共分析了98例AML儿童，平均年龄5.6岁，年龄从3个月到15岁不等。男女之比为1.8：1，诱导后完全缓解率为82.6%。化疗期间复发者46例(46.9%)，化疗结束后复发者19例(19.4%)。3年总生存率为23.2%。3年无事件生存率为20.2%。遗弃4例(4.1%)。在研究期间，通过财务支持、管理家庭小组、提供教育、对错过预约的患者进行早期跟进以及为患者/家人提供医院附近的免费住宿等整体策略，成功地减少了遗弃。诱导期完全缓解率高(82.6%)，但3年总生存率和无事件生存率仍较低(分别为23.2%和20.2%)。它反映出，在低收入和中等收入国家成功治疗急性髓细胞白血病非常困难。我们正在考虑如何提高我院儿童急性髓系白血病的治疗质量。
Acute Myeloid Leukemia (AML) in children is a serious disease. With a proper treatment, a long-term survival rate above 50% is typical. Before 2010, all the AML patients died in our hospital, and abandonment rate was more than 50%. The aims of this study are to explore the long-term outcome of newly childhood acute myeloid patients treated at Hue Central Hospital from 2010 to 2019.A retrospective study was conducted on 98 children with AML who admitted Hue Central Hospital from January 2010 to December 2019. The diagnosis was confirmed by morphological FAB criteria, cytochemistry and immunophenotype. Patients were treated with using modified AML 7-3 Regimen. Social supports were provided to patients/families. A total of 98 children with AML were analyzed with mean age of 5.6 years ranging from 3 months to 15 years. The male to female ratio was 1.8:1. The overall complete remission rate after induction were 82.6%). Patients accounted for 46 (46.9%) had relapses which occurred in during chemotherapy n=27 (27,6%), after finishing chemotherapy n=19(19,4%). Overall survival at 3 years were 23.2%. The event-free survival at 3 years were 20.2%. Abandonment cases were 4 (4.1%). During the period study, abandonment has been reduced successfully with holistic strategies such as financial support, managing family group, providing education, early follow-up of patients who missed appointments and free accommodation near hospital for patients/families. However, with a high rate patient achieved complete remission after induction phase (82.6%), but the overal survival and event-free survival at 3 years were still low in my hospital (23.2 % and 20.2% respectively). It reflected that it was very difficult to treat successfully AML in low- and middle-income countries. We are considering the way how to improve the quality treatment for childhood acute myeloid leukemia in my hospital.