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目的探索采用减低强度、低费用的治疗方案治疗儿童非高危急性淋巴细胞白血病(ALL)的可行性及其在发展中国家的现实意义。方法1999年5月-2006年9月本院儿科病房初诊的ALL患儿52例。男40例,女12例;年龄1～14岁。家长在充分知情的情况下自主选择是否接受低强度低费用经济方案治疗。经济方案的长期疗效用Kaplan-Meier生存分析方法统计,住院费用来自医院病案室。结果选择经济方案治疗的患儿均来自低收入家庭。52例诱导失败3例。其中2例诱导未缓解,1例诱导未结束放弃治疗。诱导缓解率94.2%,非高危ALL患儿4a和7a预期无事生存率(pEFS)分别为72.8%和67.2%,4a和7a预期无病生存率(pDFS)分别为74.3%和68.6%。住院化疗费用2.3万～5.1万元(中位数3.2万)。结论低强度经济方案治疗儿童非高危ALL似能达到合理的EFS和DFS,对低收入家庭儿童的治疗有现实意义。
Objective To explore the feasibility of using non-high-risk acute lymphoblastic leukemia (ALL) in treatment of children with low-intensity and low-cost treatment and its practical significance in developing countries. Methods From May 1999 to September 2006, 52 cases of ALL children newly diagnosed in pediatric ward of our hospital were enrolled. 40 males and 12 females; aged 1 to 14 years old. Parents choose whether or not to accept low-cost low-cost economic programs under fully informed circumstances. Long-term efficacy of economic programs using Kaplan-Meier survival analysis statistics, hospitalization costs from the hospital case. Results The children who were treated with economic option were all from low-income families. Three cases were induced failure in 52 cases. Among them, 2 cases did not induce remission and 1 case did not give up treatment. The expected response-free survival (pEFS) of non-high-risk ALL children was 72.8% and 67.2% respectively, and the expected disease-free survival rates (pDFS) of 4a and 7a were 74.3% and 68.6%, respectively. Hospitalization costs 23,000 ~ 51,000 yuan (median 32,000). Conclusion Low-intensity economic treatment of children with non-high-risk ALL seems to achieve a reasonable EFS and DFS, for low-income families of children with practical significance.