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目的探索在基层医院采用先进的诊疗技术治疗儿童血液肿瘤的可能性和远期疗效。方法采用文献报道的同济95-1(TJ95-1)方案治疗儿童急淋白血病(ALL)和晚期非霍奇金淋巴瘤(NHL),统计远期疗效。并积极防治强烈化疗后并发症,提高医疗安全。结果近4年中分别治疗6例ALL和3例Ⅳ期NHL,平均随访时间25个月。9例病儿经过诱导治疗后均获得完全缓解(CR),目前3例已经完成3.5年的计划总疗程,停药随访中;其余6例仍CR中,其中1例CR已3年,2例CR超过2年,无1例复发。采用积极的化疗并发症防治措施,病儿均能够度过骨髓抑制期,未出现重要脏器明显损伤和化疗相关死亡。结论初步结果显示,在基层单位采用先进治疗方案,以及积极的化疗并发症防治措施,还是完全能够开展儿童血液肿瘤的现代治疗,并获得较佳的远期疗效。
Objective To explore the possibility and long-term curative effect of using advanced diagnosis and treatment techniques to treat hematological malignancies in children in primary hospitals. Methods Tongji 95-1 (TJ95-1) was used in the treatment of children with acute lymphoblastic leukemia (ALL) and advanced non-Hodgkin lymphoma (NHL), and the long-term efficacy was calculated. And actively prevent and treat post-chemotherapy complications, improve medical safety. Results 6 cases of ALL and 3 cases of stage IV NHL were treated in the recent 4 years with an average follow-up time of 25 months. 9 cases of children were treated with induction therapy were completely relieved (CR), the current 3 cases have completed 3.5 years of total planned treatment, discontinuation of follow-up; the remaining 6 cases were still CR, CR in 1 of 3 years, 2 cases CR more than 2 years, no recurrence in 1 case. The use of active chemotherapy complications prevention and treatment measures, sick children can spend myelosuppression period, no significant organ damage and chemotherapy-related deaths. Conclusions The preliminary results show that adopting advanced treatment programs in grass-roots units and active prevention and treatment of chemotherapy complications are still entirely capable of modern treatment of children with hematological tumors and obtaining better long-term results.