用修改的BFM-2009协议治疗儿童急性淋巴细胞白血病的结果,使用可测量的残留疾病基于风险分层:单中心研究
Sanjeev Khera1, M K Safal Muhammed2, Rajiv Kumar3
1Department of Pediatrics, Army Hospital (Research & Referral), Delhi, India. kherakherakhera@gmail.com.
Indian pediatrics
|February 12, 2026
概括
调整化疗方案,如修改的柏林 - 法兰克福 - 蒙斯特 (BFM) - 2009年,在低收入国家显著改善了儿童急性淋巴细胞白血病 (ALL) 的治疗结果. 这种方法提高了生存率,并减少了儿科癌症患者的复发.
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:
- 高收入国家的标准化疗方案往往在低收入和中低收入国家 (LMICs) 产生低于最佳的结果.
- 急性淋巴细胞白血病 (ALL) 是一种常见的儿童癌症,有效的治疗方案对于改善生存率至关重要.
- 柏林-法兰克福-蒙斯特 (BFM) 协议是广泛用于儿童ALL的治疗方案.
研究的目的:
- 在被诊断患有急性淋巴细胞白血病 (ALL) 的儿童中分析修改的柏林-法兰克福-蒙斯特 (BFM) -2009协议的治疗结果.
- 评估适应标准化疗方案的有效性和安全性,以适应印度北部的第三级护理转诊中心的特定环境.
- 评估风险分层对LMIC环境中的儿科ALL患者治疗结果的影响.
主要方法:
- 进行了一项回顾性研究,涉及166名新诊断ALL的儿童.
- 患者接受了经过修改的BFM-2009协议的治疗,采用风险分层方法.
- 随访数据被收集和分析,以确定无事件生存率 (EFS) 和总生存率 (OS).
主要成果:
- 该研究观察到,标准风险患者的36个月无事件生存率 (EFS) 为95.7%,中等风险患者为83%,高风险患者为76.9%.
- 36个月的整体存活率为96.5% (SR),85% (IR) 和79% (HR),表明风险组的良好结果.
- 普雷尼索隆不良反应 (PPR) 和中等/高风险 (IR/HR) 分层与较差的EFS有关,突出了关键的预后因素.
结论:
- 适应国际化疗协议,而不是严格采用它们,对于改善LMIC中儿童ALL的结果至关重要.
- 修改后的BFM-2009协议在印度的第三级护理环境中显示出良好的治疗结果,表明成功适应.
- 风险分层和监测像PPR这样的治疗反应标志物对于优化儿童ALL患者的护理和改善资源有限的环境中的存活率至关重要.
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