儿童急性淋巴细胞白血病死亡的原因:一个单一中心的经验
Matej Jelić1, Maja Pavlović1, Lucija Mucavac1
1Division of Hematology and Oncology, Department of Pediatrics, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia.
Medicina (Kaunas, Lithuania)
|July 30, 2025
概括
复发和感染是儿科急性淋巴细胞白血病 (ALL) 中的主要死亡原因. 生存结果受到复发时间和风险组的显著影响,特别是在诱导和再诱导阶段.
科学领域:
- 儿科瘤学 儿科瘤学
- 血液学 血液学 血液学
- 临床研究 临床研究
背景情况:
- 急性淋巴细胞白血病 (ALL) 是一种普遍存在的儿童癌症.
- 由于风险分层,治疗和支持性护理的进步,生存率有所改善.
研究的目的:
- 审查儿童ALL的流行病学,预后因素和死亡原因.
- 确定影响儿科ALL患者临床结果的风险因素.
主要方法:
- 对302名被诊断患有ALL的儿童 (0-18岁) 的回顾性研究.
- 从2001年1月到2015年12月在第三级护理中心收集的数据.
主要成果:
- 总体生存率为83% (251名幸存者).
- 复发发生在13.6%的患者中;B细胞前体 (Bcp) -ALL高于T细胞ALL.
- 死亡的主要原因:耐药/复发性疾病 (43%),感染 (35%),GVHD (8%).
- Pseudomonas aeruginosa 和 Aspergillus fumigatus 是常见的传染病死亡原因.
- 复发时间和风险组独立预测结果;没有复发的T细胞ALL幸存者.
结论:
- 复发和感染是儿童ALL死亡的主要原因.
- 在诱导和再诱导阶段观察到的最高死亡率.
- 复发时间和风险组显著影响儿科ALL的存活率.
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