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目的探讨应用格列卫(甲磺酸伊马替尼)联合CCLG-2008方案治疗儿童费城染色体阳性(Ph+)急性淋巴细胞白血病(ALL)的疗效及对预后的影响。方法 11例儿童ALL经骨髓细胞形态学、细胞化学、免疫学分型、融合基因检测确诊为费城染色体阳性B细胞ALL。采用CCLG-2008方案化疗,期间加用格列卫口服治疗。结果疗程第33 d骨髓检查9例得到缓解(缓解率81.9%),1例于第二疗程加用格列卫治疗后缓解,1例持续不缓解,放弃治疗后死亡。监测BCR/ABL融合基因,9例转阴(中位转阴时间118.5 d),最短转阴时间是43 d,最长194 d;1例治疗4个月,基因未转阴,放弃治疗,1例治疗24个月,基因持续阳性,骨髓处于缓解状态,中位随访时间为29个月。结论格列卫联合CCLG-2008方案治疗Ph+儿童ALL,对提高患儿血液学缓解率,提高BCR/ABL基因的转阴率有意义。能否提高经化学治疗的长期生存率,有待继续观察。
Objective To investigate the curative effect and prognosis of glioma-positive (Ph +) acute lymphoblastic leukemia (ALL) in children with Glivec (imatinib mesylate) and CCLG-2008 regimen. Methods Eleven children with ALL were diagnosed as Philadelphia chromosome positive B cells ALL by morphology, cytochemistry, immunological typing and fusion gene test. The use of CCLG-2008 chemotherapy, with oral treatment of Gleevec. Results The bone marrow examination on the 33rd day of treatment was alleviated in 9 cases (response rate was 81.9%). One case was relieved after the second course of treatment was treated with Gleevec. One case continued to be non-relieved and died after giving up treatment. The BCR / ABL fusion gene was detected in 9 patients with negative conversion (median conversion time was 118.5 days). The shortest negative conversion time was 43 days and the longest was 194 days. One case was treated for 4 months, Cases of treatment for 24 months, the gene continued positive, bone marrow in remission, the median follow-up time was 29 months. Conclusion The combination of Gleevec and CCLG-2008 regimen in treating Ph + childhood ALL is significant for improving the hematological response and improving the rate of BCR / ABL negative conversion in children. Can improve the long-term survival by chemotherapy, pending further observation.