原血细胞对于儿童急性B淋巴细胞白血病预后判断的价值

Prognostic value of bone marrow hematogones in childhood B-lineage acute lymphoblastic leukemia

摘要:

目的 探讨儿童急性B 淋巴细胞白血病(B-ALL)巩固化疗期骨髓原血细胞(HGs)对于儿童急性B 淋巴细胞白血病(B-ALL)预后判断的意义.方法 回顾性分析196 例初发B-ALL 患儿,根据危险分型分为高危(n=55)、中危(n=69)和低危(n=72)3 组;根据临床结局分为完全缓解(n=165)和复发组(n=31).采用欧洲BIOMED-1 标准化流式细胞术微小残留病(MRD)检测方案,检测巩固化疗期HGs 数量.Kaplan-Meier 生存曲线统计患儿无事件生存率(EFS).结果 高危组患儿HGs 明显低于中危和低危组,差异均有统计学意义(P<0.05);完全缓解组HGs 明显高于复发组,差异有统计学意义(P<0.05);HGs ≤ 1.0% 组患儿的EFS 明显低于 HGs>1.0% 组,差异有统计学意义(P<0.05).结论 HGs 可反映B-ALL 化疗效果,可用于B-ALL患儿疗效及预后的监测.

Abstract:

Objective To study the prognostic value of hematogones (HGs) for childhood B-lineage acute lymphoblastic leukemia (B-ALL) during consolidation chemotherapy. Methods A retrospective analysis was conducted for 196 children with newly-diagnosed B-ALL. They were divided into high-risk group (n=55), intermediate-risk group (n=69), and low-risk group (n=72) by risk stratification, and into complete remission group (n=165) and relapse group (n=31) by clinical outcome. The European BIOMED-1 standard flow cytometry for minimal residual disease (MRD) was used to determine the number of HGs during consolidation chemotherapy. The Kaplan-Meier survival curve was used to assess event-free survival (EFS). Results The high-risk group had a significantly lower number of HGs than the intermediate-risk and low-risk groups (P<0.05). The number of HGs in the complete remission group was significantly higher than in the relapse group (P<0.05). The children with HGs ≤1.0% had a significantly lower EFS than those with HGs >1.0% (P<0.05). Conclusions HGs can be used to assess the treatment outcome and prognosis in children with B-ALL, and proliferation of HGs reflects the good effect of chemotherapy in such children.