Objective: To investigate the effect of course delay of CCLG-ALL-2008 regimen on the relapse of paediatric B-cell acute lymphoblastic leukemia (B-ALL) patients.
Methods: Paediatric B-ALL patients newly diagnosed and treated with CCLG-ALL-2008 regimen in the Children's Hospital of Soochow University from January 2011 to December 2014 were retrospectively analyzed to clarify the relationship between chemotherapy course delay and relapse, and explore the causes of course delay which led to relapse. Patients were followed up until July 2019.
Results: The correlation between treatment delay (number of weeks) and relapse rate was statistically significant (P=0.034), and hazard ratio indicated that longer than 4 weeks had a significant effect. The effect of positive minimal residual disease (MRD) (1×10-4≤MRD≤1×10-2) at the 12th week on the relapse rate was also statistically significant (P=0.041). Among the causes of treatment delay, the effect of myelosuppression on the relapse rate was statistically significant (P=0.01).
Conclusion: Treatment delay exceeding 4 weeks, positive MRD at the 12th week, and myelosuppression are independent prognostic factors for relapse.
题目: 疗程拖延对儿童急性B淋巴细胞白血病复发的影响.
目的: 探讨急性B淋巴细胞白血病患儿采用CCLG-ALL-2008方案疗程拖延对疾病复发的影响。.
方法: 对2011年1月至2014年12月在苏州大学附属儿童医院初诊并接受CCLG-ALL-2008方案治疗的急性B淋巴细胞白血病患儿进行回顾性分析，明确化疗疗程拖延与复发的关系，并探究导致疗程拖延引起复发的原因，随访至2019年7月。.
结果: 疗程拖延周数对复发率的影响具有统计学意义（P=0.034），风险率比提示大于4周影响显著。第12周微小残留病阳性（1×10-4≤微小残留病≤1×10-2）对复发率的影响亦有统计学意义（P=0.041）。在疗程拖延原因中，单纯骨髓抑制对复发率的影响有统计学意义（P=0.01）。.
结论: 疗程拖延4周以上、第12周微小残留病阳性和单纯骨髓抑制是影响复发的独立预后因素。.
Keywords: B-cell acute lymphoblastic leukemia; CCLG-ALL-2008 regimen; chemotherapy delay; child; relapse.