[A retrospective analysis of clinical outcomes in 225 childhood with acute lymphoblastic leukemia].
OBJECTIVE
To retrospectively analyze the outcomes in newly diagnosed children with acute lymphoblastic leukemia (ALL).


METHODS
Two hundred and twenty-five children with ALL (from Jan 2003 to Dec 2006) were divided into high-(HR) and standard-risk (SR) groups according to cytomorphology, immunology, cytogenetics and molecular biology (MICM) finding. SR patients were treated with conventional therapy, while HR patients with additional high-dose (HD) methotrexate (MTX) (5 g/m(2)) and early mid-dose cytarabine (Ara-C) (1 g/m(2), q 12 h x 3 d). All patients took maintenance chemotherapy of MM+VP. Respond rate (RR) and overall survival (OS) rate of patients were retrospectively analyzed.


RESULTS
The probabilities of 3-year and 5-year OS were 79.0% and 72.6%, respectively. The SR patients had a remarkably higher 3-year OS (87.6%) than that of HR patients (66.1%) (P = 0.002).


CONCLUSIONS
(1) Early intensive therapy with mid-dose Ara-C and HD-MTX significantly improves the outcome of HR children with ALL. (2) The early intensive therapy in HR patients reduces the incidence of CNSL. (3) Periodic intensification and more re-induction therapies in SR patients remarkably improves the long-term survival.
Chen
Xiao-Juan
XJ
Institue of Hematology and Blood Diseases Hospital, CAMS, Tianjin 300020, China.
Zhang
Li
L
Liu
Tian-Feng
TF
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D003561:Cytarabine; D008727:Methotrexate