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目的：观察强烈化疗治疗小儿急性淋巴细胞白血病（ＡＬＬ）的疗效。方法：８３ 例ＡＬＬ患儿用ＣＯＤＰＬ方案诱导治疗，缓解后用ＣＡＴ、ＨＤＭＴＸ、ＥＡ、ＶＰＤＬ方案早期巩固强化治疗，用ＭＴＸ、６－ＭＰ、ＶＰ、ＣＯＰ、Ａｒａ－Ｃ维持治疗，用ＣＯＡＰ、ＥＡ、ＶＰＤＬ方案定期加强治疗，用ＨＤＭＴＸ联合三联鞘注对庇护所白血病进行预防。结果：完全缓解（ＣＲ）率９６．４％ （８０／８３）；３ 例在诱导期死于败血症。６８例坚持治疗的患儿，中位随访３７（１８～１０８）个月，５ 年持续完全缓解（ＣＣＲ）率７６．２％ 。标危ＡＬＬ和高危ＡＬＬ的５ 年ＣＣＲ率分别为７９．６％ 和７２．９％ 。结论：强烈化疗及坚持治疗是提高小儿ＡＬＬ５年ＣＣＲ率的关键；严重感染仍是治疗失败的主要原因。
Objective: To observe the effect of intensive chemotherapy on children with acute lymphoblastic leukemia (ALL). METHODS: Eighty-three children with ALL were induced with CODPL regimen and were treated with CAT, HDMTX, EA and VPDL for early consolidation and intensive treatment. The patients were treated with MTX, 6-MP, VP, COP and Ara- The VPDL regimen was regularly enhanced to prevent asymptomatic leukemia with HDMTX in combination with triple-sheaths. Results: The complete remission (CR) rate was 96.4% (80/83). Three patients died of sepsis during the induction period. Sixty-eight patients were followed up for a median follow-up of 37 (18-108) months, with a 5-year sustained rate of complete remission (CCR) of 76.2%. The 5-year CCR rates of standard-risk ALL and high-risk ALL were 79.6% and 72.9%, respectively. Conclusion: Intense chemotherapy and persistent treatment are the keys to improve the CCR rate in children with ALL5. Serious infection is still the main reason for the failure of treatment.