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目的探讨泼尼松诱导试验评估儿童急性淋巴细胞白血病(ALL)预后的价值。方法126例ALL初治患儿按ALLXH99治疗方案行泼尼松诱导试验,口服泼尼松(60mg/m2)7d和氨甲蝶蛉加阿糖胞苷鞘内注射1次后外周血涂片计数幼稚淋巴细胞数。若幼稚淋巴细胞数<1000/μL,为泼尼松反应良好;如幼稚淋巴细胞数≥1000/μL,为泼尼松反应不良。生存分析采用KaplanMeier方法;各组生存的比较采用logrank检验;各生物学特征的比较采用χ2检验或Fisher确切概率法(双尾)。结果110例患儿表现为泼尼松反应良好,16例患儿表现为泼尼松反应不良;5年无事件生存率(pEFS)分别为73%±5%与48%±13%,差异有统计学意义(P=0.0021)。结论泼尼松诱导试验简单,易操作,可方便地评估早期治疗反应。
Objective To investigate the value of prednisone induction test in assessing the prognosis of childhood acute lymphoblastic leukemia (ALL). Methods A total of 126 ALL patients undergoing ALLXH99 treatment were given prednisone induction test. Peripheral blood smear count was determined after oral administration of prednisone (60 mg / m2) for 7 days and intrathecal injection of methotrexate plus cytarabine Childish lymphocytes. If the number of naive lymphocytes <1000 / μL, for the good response to prednisone; such as naive lymphocytes ≥ 1000 / μL, prednisone reaction is poor. Survival analysis using KaplanMeier method; survival comparison of each group using logrank test; the biological characteristics of the comparison using the χ2 test or Fisher exact test (two-tailed). Results One hundred and ten children presented with good prednisone response and 16 children with prednisone response. The 5-year event-free survival (pEFS) was 73% ± 5% and 48% ± 13%, respectively Statistical significance (P = 0.0021). Conclusion Prednisone induction test is simple, easy to operate, can easily assess the early response to treatment.