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目的分析70例ALL患儿分型治疗的长期疗效和远期不良反应,以寻求提高患儿长期高质量无病生存的方法。方法随访并分析2000年1月-2009年12月在本院儿科血液/肿瘤病房诊断并坚持治疗的70例ALL患儿情况。临床分型:标危型、中危型、高危型和ALL-L3型患儿分别为42、12、7例和9例。采用Kaplan-Meier方法进行长期生存情况分析。结果 5 a无事件生存率在标危组、中危组和ALL-L3组分别为(93.87±4.22)%、(85.33±6.45)%和(88.89±7.48)%。高危型患儿目前无病存活率为42.86%(3/7例)。复发6例(8.57%),其中死亡4例,另有5例无复发死亡,总病死率12.86%。长期不良反应观察未发现二次肿瘤及蒽环类心肌病发生,4例(5.71%)患儿生长受限,1例患儿发生单侧股骨头无菌性坏死。结论分型治疗可提高ALL患儿长期生存率,改善ALL患儿生存的质量。
Objective To analyze the long-term efficacy and long-term adverse reactions in 70 children with ALL and to find ways to improve their long-term, high-quality disease-free survival in children. Methods Follow-up and analysis of 70 cases of ALL children diagnosed and adhering to treatment in our pediatric blood / tumor ward from January 2000 to December 2009 were performed. Clinical classification: standard type, medium risk type, high risk type and ALL-L3 type were 42,12,7 cases and 9 cases. Kaplan-Meier method for long-term survival analysis. Results The 5-year event-free survival rate was (93.87 ± 4.22)%, (85.33 ± 6.45)% and (88.89 ± 7.48)% in standard risk group, moderate risk group and ALL-L3 group respectively. The prevalence of disease-free survival in high-risk children is 42.86% (3/7 cases). Recurrence occurred in 6 cases (8.57%), including 4 deaths and 5 deaths without recurrence, with a total case fatality rate of 12.86%. Long-term adverse reactions observed no secondary tumor and anthracycline cardiomyopathy occurred, 4 cases (5.71%) of children with limited growth, 1 case of unilateral necrosis of the unilateral femoral head necrosis occurred. Conclusion The typing treatment can improve the long-term survival rate of children with ALL and improve the quality of life of children with ALL.