• 作者：Susana Rives^a ; ^{srives@hsjdbcn.org} ; Jesú ; s Estella^a ; Mireia Camó ; s^b ; Purificació ; n Garcí ; a-Miguel^c ; Amparo Verdeguer^d ; José ; Miguel Couselo^e ; Marí ; a Tasso^f ; Javier Molina^g ; Pedro Gó ; mez^h ; Rafael Ferná ; ndez-Delgadoⁱ ; Aurora Navajas^j ; Isabel Badell^k ; en representació ; n del grupo cooperativo SHOP (Sociedad Españ ; ola de Hemato-Oncologí ; a Pediá ; trica)^&loz ;
• 关键词：Leucemia linfoblá ; stica aguda T ; Pediá ; trica ; Factores pronó ; sticos
• 刊名：Medicina Cl篓陋nica
• 出版年：2012
• 期刊代码：pca254_00257753
• 类别：med
• 出版时间：7 July, 2012
• 卷：139
• 期：4
• 页码：141-149
• 文件大小：458 K

Background and objectives

Acute lymphoblastic leukemia (ALL) is the most frequent cancer in childhood, with cure rates of 80-85%. In T-cell ALL (15%of ALL), prognostic factors are ill defined. We aimed to describe the event-free survival (EFS) and analyze clinical prognostic factors in a series of pediatric T-ALL of 4 consecutive clinical trials.

Patients and methods

Children with T-ALL aged 1-18 years treated in 37 institutions in Spain were enrolled in 4 consecutive trials from February-1989 to November-2009.

Results

A total of 218 T-ALL patients out of 1,652 pediatric ALL were evaluable during the study period (SHOP/ALL-89: 35, ALL-94: 63, ALL-99: 62, ALL-2005: 58). There were 164 boys (75%). Median age (years) was 7.8 range (1.3-18.6). Median leukocytes (10⁹/L) was 78.2, range 0.8-930. Fifteen (6.8%) children had central nervous system (CNS) involvement at diagnosis. Regarding response to induction treatment, 150 (75%) patients had less than 5%blasts on day-14 bone marrow and 199 achieved complete remission at the end of induction. Overall survival (OS) at 60 months for SHOP/ALL-89, ALL-94, ALL-99 was 48 (8), 49 (6), 70 (6)%, respectively, and at 48 months for SHOP/ALL-2005 (ongoing protocol) was 74 (8)%. Median follow-up (months) was 206, 152, 74 and 17 respectively. Analysis of prognostic factors revealed no statistical differences regarding sex or age. Leukocyte count over 200 脳 10⁹/l (P = .024), CNS infiltration at diagnosis (P < .006) and treatment response had prognostic significance (end-induction complete remission) (P = .0000), day 14-bone marrow (P = .005).

Conclusions

Results for the SHOP/ALL-89 and ALL-94 protocols were inferior to other contemporary protocols but there has been an improvement in survival in the 2 last trials. In line with other T-ALL series, response to treatment had the strongest prognostic impact.