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目的观察含培门冬酶的VDPAP方案治疗儿童急性淋巴细胞白血病的疗效。方法对51例初发急性淋巴细胞白血病患儿,其中对照组28例患儿按照上海儿童医学中心ALL-XH-99方案给予VDLP进行诱导缓解治疗和巩固强化治疗;试验组23例患儿将治疗方案中的左旋门冬酰胺酶改为培门冬酶,余方案不变,进行诱导缓解治疗和巩固强化治疗,观察两组患儿的疗效和不良反应。结果试验组的完全缓解率为91.3%,低于对照组的92.8%,但差异无统计学意义;试验组2年无进展生存率为69.5%,总生存率为86.9%;对照组2年无进展生存率为60.7%,总生存率为82.1%,两组间比较差异无统计学意义(P>0.05),两组不良反应比较,试验组肝功能损害发生率低于对照组,差异有统计学意义(P<0.05),且试验组患儿无严重过敏反应发生。结论培门冬酶在治疗儿童急性淋巴细胞白血病中具有与左旋门冬酰胺酶相当的疗效和较低的不良反应。
Objective To observe the efficacy of VDPAP with pepsinase in the treatment of childhood acute lymphoblastic leukemia. Methods Totally 51 children with acute lymphoblastic leukemia were enrolled in this study. Twenty-eight children in the control group were treated with VDLP according to ALL-XH-99 regimen in Shanghai Children’s Medical Center. Forty-three children in the experimental group were treated L-asparaginase in the protocol was changed to pegaspargase and the remaining protocol was unchanged. Induction remission therapy and consolidation intensive therapy were performed to observe the curative effect and adverse reactions in both groups. Results The complete remission rate of the experimental group was 91.3%, which was lower than that of the control group (92.8%), but the difference was not statistically significant. The 2-year progression-free survival rate was 69.5% in the trial group and the overall survival rate was 86.9% Progressive survival rate was 60.7%, overall survival rate was 82.1%, no significant difference between the two groups (P> 0.05), two groups of adverse reactions, the incidence of liver dysfunction in the experimental group was lower than the control group, the difference was statistically Significance (P <0.05), and no severe allergic reaction occurred in the experimental group. Conclusion Pegasys have comparable efficacy and lower adverse reactions than L-asparaginase in the treatment of childhood acute lymphoblastic leukemia.