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目的 :分析 Ph阳性急淋的细胞遗传学、临床疗效及预后 ,并对比成人和儿童患者的临床特点。方法 :总结 2 1例初治 Ph阳性急淋患者的 CR率 ,以及不同巩固方案的疗效 ,同时对白血病细胞的生物学特征进行研究。结果 :儿童与成人患者在疗效以及预后方面无显著性差异 ( P<0 .0 5 ) ;本组患者 CR率为 76 % ;在各种不同巩固方案中 ,大剂量 Ara-C DF S为 ( 10 .944± 1.774)月 ,中位生存时间 19月 ,未用大剂量 Ara-C DFS为 ( 2 .840± 0 .95 5 )月 ,中位生存时间 8月 ,P值分别为 0 .0 0 3、0 .182 ;CTX/VP1 6使用者 DFS为 ( 7.6 6 7± 1.85 8)月 ,中位生存时间 19月 ,未用 CTX/VP1 6DFS为 ( 2 .75 3± 1.0 46 )月 ,中位生存时间 8月 ,P值分别为 0 .0 395、0 .0 32 6。结论 :儿童与成人Ph阳性急淋临床表现相似 ,预后较差。巩固强化治疗使用大剂量 Ara-C、含 CTX/VP1 6的方案可能取得相对较好的疗效 ,但由于例数尚少 ,尚难下定论
Objective : To analyze the cytogenetics, clinical efficacy and prognosis of Ph-positive acute leukemia, and to compare the clinical features of adult and pediatric patients. Methods: To summarize the CR rate of 21 patients with newly diagnosed Ph-positive acute leukemia and the efficacy of different consolidation strategies. At the same time, the biological characteristics of leukemia cells were studied. Results: There was no significant difference in efficacy and prognosis between children and adults (P<0.05). The CR rate in this group was 76%. In different consolidation schemes, the large dose of Ara-C DF S was ( (10.944±1.74) months, with a median survival time of 19 months, no high-dose Ara-C DFS was (2.840±0.055) months, median survival time was 8 months, and P value was 0. 0 3, 0 .182; DTX of CTX/VP1 6 users was (7.6 67 ± 1.85 8) months, median survival time was 19 months, and CTX/VP1 6DFS was not used (2.753 ± 1.046) months. The median survival time was 8 months, and the P values were 0. 0 395, 0. 0 32 6. Conclusion: The clinical manifestations of Ph-positive acute leukemia in children and adults are similar and the prognosis is poor. Consolidation of intensive treatment with high-dose Ara-C and CTX/VP16-containing regimens may yield relatively good results, but it is difficult to determine the number of cases due to the small number of cases.