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作者根据急性淋巴细胞白血病(ALL)患儿在诊断时有无一些危险因素存在,前瞻性安排了289例ALL的患儿接受一个或两个方案的化疗。其中标危组110例,年龄2—9岁,并具以下特征:白细胞<20 000/mm~3,无T细胞免疫学标记,放射学检查没有纵膈肿块;诊断时没有中枢神经系统白血病的临床体征或细胞学证据。高危组179例,且有一项或一项以上危险因素:年龄<2岁或>9岁,白细胞≥2 0000/mm~3,有T细胞免疫学标记,放射学检查有纵膈肿块和有中枢神经系统受累的证据,标危及高危组都接受2年的治疗,包括诱导缓解,强化治疗和中枢神经系统白血病的预防。两组病人的诱导缓解是随机选用静注(iv)大剂量氨甲喋呤(MTX)4g/m~2或33g/
According to the authors of this study, 289 ALL patients were prospectively scheduled for either one or two regimens based on the presence or absence of risk factors for the diagnosis of acute lymphoblastic leukemia (ALL). The standard risk group of 110 patients, aged 2-9 years, and has the following characteristics: white blood cells <20 000 / mm ~ 3, no T-cell immunological markers, radiological examination without mediastinal mass; diagnosis of central nervous system leukemia Clinical signs or cytological evidence. There were 179 high-risk patients with one or more risk factors: age <2 years or> 9 years old, white blood cells≥2 0000 / mm ~ 3, T cell immunological markers, radiological examination with mediastinal mass and central Evidence of neurological involvement, standard and high-risk groups received 2 years of treatment including induction of remission, intensive treatment and prevention of central nervous system leukemia. Induction of remission was randomized to either iv (iv) high dose methotrexate (MTX) 4g / m ~ 2 or 33g /