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本文研究190例14岁以下的儿童 ALL。这些患者均接受诱导治疗、足够的中枢神经系统预防和至少2种有效制剂的联合维持治疗直至复发。作者分析了复发后的生存期、获得第2次缓解的比例和第2次血液学缓解及完全缓解时间。复发的190例儿童 ALL 中,4例(2.1%)复发为非淋巴细胞白血病;93例(49%)获得第2次缓解,其中数血液学缓解期为97天,完全缓解期80天。第2次复发84例,内20例(23.8%)取得第3次缓解。第3次复发17例中有2例(11.8%)达到第4次缓解,随后在第4次复发中死亡。所有复发后190例儿童 ALL 的中数生存期157天,但未有超过2年3个月者。诊断时白细胞计数和首次缓解期的长短:诊断时白细胞数高者,其复发后生存期较短。复发后生存期与年龄、性别、首次诱导缓解的药物数目以及首次缓解期的长短无关。次首缓解期较短者,生存期亦短。复发较早的儿童,开始时有较高的白细胞数倾向。而这种因素都不影响取得第2次缓解的机会。但在诊断时
This article studies 190 ALL children under 14 years of age. These patients received induction therapy, adequate central nervous system prophylaxis and combined maintenance therapy with at least 2 active agents until recurrence. The authors analyzed the post-recurrence survival, the percentage of second remissions, and the second hematologic remission and complete remission. Of the 190 relapsed children with ALL, 4 (2.1%) relapsed to non-lymphocytic leukemia; 93 (49%) achieved the second remission, with a number of hematologic remissions of 97 days and complete remission of 80 days. The second relapse was 84 cases, and the second 20 cases (23.8%) achieved the third remission. In the third relapse of 17 cases, 2 (11.8%) achieved the 4th remission and subsequently died in the 4th relapse. The median survival time of ALL for all 190 children after relapse was 157 days but not more than 2 years and 3 months. The number of white blood cell counts and the period of first remission at the time of diagnosis: The number of white blood cells at the time of diagnosis was high, and the survival time was shorter after relapse. The survival period after relapse was not related to age, gender, number of drugs for first induction of remission, and length of first remission period. The shorter remission period in the second, the shorter survival period. Early relapsed children tend to have a higher white blood cell count initially. And this factor does not affect the chance of achieving the second mitigation. But at the time of diagnosis