儿童非核心结合因子急性髓系白血病的疗效及预后因素分析

Efficacy and prognostic factors in children with non-core binding factor acute myeloid leukemia

摘要:

目的 回顾性分析比较非核心结合因子（CBF）急性髓系白血病（AML）儿童采用CAMS-2005方案及CAMS-2009方案治疗的疗效及预后的影响因素。方法 选择2005年4月至2015年12月161例初诊为非CBF-AML患儿为研究对象，根据化疗方案分为CAMS-2005方案组（n=52）和CAMS-2009方案组（n=109），对两种化疗方案疗效进行回顾性分析。结果 CAMS-2009方案组第1个疗程完全缓解率高于CAMS-2005方案组（63.3% vs 46.2%，P < 0.05）。CAMS-2009方案组治疗相关病死率（11.9% vs 17.3%）、复发率（27.5% vs 28.8%）、3年总生存（OS）率（44%±5% vs 28%±6%）与CAMS-2005方案组相比差异无统计学意义（P > 0.05）。第1个疗程获得完全缓解患儿的3年OS率、3年无事件生存率高于第1个疗程未完全缓解患儿（P < 0.01）。结论 CAMS-2009方案较CAMS-2005方案可改善非CBF-AML患儿诱导治疗完全缓解率，第1个疗程是否获完全缓解可影响非CBF-AML患儿OS率。

Abstract:

Objective To compare the efficacy of the CAMS-2005 and CAMS-2009 regimens in treating children with non-core binding factor acute myeloid leukemia (non-CBF AML) and to study the prognosis factors. Methods A total of 161 children who were initially diagnosed with non-CBF AML from April 2005 to December 2015 were enrolled as study subjects, and were divided into a CAMS-2005 regimen group (n=52) and a CAMS-2009 regimen group (n=109) according to the chemotherapy regimen provided. The efficacy was retrospectively compared between the two groups. Results The complete remission (CR) rate at the first course of treatment was higher in the CAMS-2009 regimen group than that in the CMAS-2005 regimen group (63.3% vs 46.2%; P < 0.05). There were no significant differences between the two groups in treatment-related mortality rate (11.9% vs 17.3%), recurrence rate (27.5% vs 28.8%), and three-year overall survival (OS) rate (44%±5% vs 28%±6%) (P > 0.05). Children who achieved CR at the first course of treatment had significantly higher OS and event-free survival rates than those who did not achieved CR (P < 0.01). Conclusions The CAMS-2009 regimen is superior to the CAMS-2005 regimen in improving the CR rate in children with non-CBF AML after induction treatment. Whether CR is achieved at the first course of treatment can affect the OS rate of children with non-CBF AML.