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目的总结应用包括大剂量阿糖胞苷(Ara-C)的短疗程化疗方案治疗儿童急性淋巴细胞白血病(ALL)的临床疗效。方法总结1992-01—2001-07在北京大学人民医院儿科初治并长期随访的ALL患儿84例,其中男52例,女32例,长期无病生存(EFS)5年以上,随访时间至2006-07。结果标危型患儿EFS率79.59%,高危型患儿的EFS率为25.81%;长期存活患儿中最长EFS为14年6个月,最短EFS为5年,中位EFS为9年11个月。有6例发生中枢神经系统白血病。未出现与大剂量Ara-C化疗相关的患儿死亡。结论(1)采用包括大剂量Ara-C的短疗程化疗方案能够获得较高的完全缓解率及EFS率,且副反应小。(2)采用该短疗程方案不加用颅脑放疗,中枢神经系统白血病的发生率无提高。(3)ALL患儿对Ara-C的敏感性存在明显的个体差异。
Objective To summarize the clinical efficacy of a short-course chemotherapy regimen including high-dose cytarabine (Ara-C) in children with acute lymphoblastic leukemia (ALL). Methods Summary From January 1992 to February 2001, 84 children with ALL who were initially treated and were followed up for a long time in Peking University People ’s Hospital were enrolled. Among them, 52 males and 32 females, with a long-term disease-free survival (EFS) of more than 5 years. The follow- 2006-07. Results The EFS rate of children with standard risk was 79.59% and that of children with high risk was 25.81%. The longest EFS of children with long-term survival was 14 years and 6 months, the shortest EFS was 5 years and the median EFS was 9 years 11 Months. There are 6 cases of central nervous system leukemia. No deaths associated with high-dose Ara-C chemotherapy occurred. Conclusions (1) A high complete remission rate and EFS rate can be obtained with short-course chemotherapy regimen including high-dose Ara-C with less side effects. (2) The use of the short course of treatment without cranial radiotherapy, no increase in the incidence of central nervous system leukemia. (3) There was a significant individual difference in the sensitivity of ALL children to Ara-C.