[Studies of children with acute lymphoblastic leukemia (ALL) who relapsed. Relationship of site of relapse, time and prognosis].
[Studies of children with acute lymphoblastic leukemia (ALL) who relapsed. Relationship of site of relapse, time and prognosis].
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[对复发的急性淋巴细胞白血病 (ALL) 儿童的研究。
DOI：
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发表时间：
1989
期刊：
影响因子：
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通讯作者：
T. Fzjimoto
中科院分区：
文献类型：
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作者：
H. Shimizu;K. Sasaki;Y. Takaue;S. Ota;T. Fzjimoto
在1981年至1988年3月参加儿童癌症和白血病研究小组研究的511名ALL儿童中，有140名患者在1988年8月之前复发。复发部位：骨髓96例(70%)，中枢神经系统36例(25%)，睾丸8例(5%)。75例急性淋巴细胞白血病首次复发患者中有57例(76%)获得了第二次完全缓解。第二次BM缓解者2年的无病生存率(DFS)为26.0%，首次缓解期的长短与预后相关。在确诊后12个月内早期骨髓复发的患者中，2年内维持二次缓解的概率为6.7%，而中期骨髓复发患者的二次缓解概率为29.8%。所有确诊后超过48个月后复发的晚期患者在没有疾病证据的情况下存活。单纯骨髓外复发患者预后良好，CNS复发者3年维持二次缓解的概率为41.4%，睾丸复发者维持二次缓解的概率为57.1%。这些数据表明，20-30%的患者在确诊后12个月以上复发是可以挽救的，但那些在确诊后12个月内在积极治疗期间复发的患者，应该考虑其他类型的治疗。
One hundred and forty patients out of 511 children with ALL who were entered in the study of the Children's Cancer & Leukemia Study Group from 1981 through March 1988 had relapsed by August 1988. The sites of relapse were BM (including concurrent CNS relapse) in 96 cases (70%), CNS in 36 cases (25%), and testicles in 8 cases (5%). A second complete remission was induced in 57 of the 75 patients (76%) with ALL in the first BM relapse. The projected disease-free survival (DFS) for those in the second BM remission was 26.0% at 2 years and the length of the first remission was correlated with the outcome. In the patients in early marrow relapse within 12 months after diagnosis, the probability of maintaining a second remission at 2 years was 6.7% compared to 29.8% in those in intermediate marrow relapse. All patients in late relapse after more than 48 months from diagnosis are surviving with no evidence of disease. The outcome of the patients with isolated extra-marrow relapse was so favorable that the probability of maintaining a second remission for those in CNS relapse was 41.4% at 3 years, and 57.1% in patients in testicular relapse. These data suggest that 20-30% of patients relapsing after more than 12 months from diagnosis may be salvaged, but those who relapsed during active therapy within the first 12 months after diagnosis, other types of treatment should by considered.