Objective: To analyze the clinical effects of CCLG-AML-2015 protocol on newly diagnosed children with acute myeloid leukemia (AML).
Methods: The clinical data of 60 newly diagnosed AML children in the Department of Hematology and Oncology, Wuhan Children's Hospital from August 2015 to September 2019 were summarized, the effect of chemotherapy using the CCLG-AML-2015 regimen (hereinafter referred to as the 2015 regimen) were retrospectively analyzed. 42 children with AML treated by the AML-2006 regimen (hereinafter referred to as the 2006 regimen) from February 2010 to July 2015 were used as control group.
Results: There were no statistical differences between the 2015 regimen group and the 2006 regimen group in sex, age at first diagnosis, and risk stratification (P>0.05). The complete remission rate of bone marrow cytology after induction of 1 course of chemotherapy (84.7% vs 73.1%, P=0.155), and minimal residual disease detection (MRD) negative (42.3% vs 41.4%, P=0.928) in the 2015 regimen group were not statistically different than those in the 2006 regimen group. The bone marrow cytology CR (98.1% vs 80.6%, P=0.004) and MRD negative (83.3% vs 52.8%, P=0.002) in the 2015 regimen group after 2 courses of induction were higher than those in the 2006 regimen group. The 5-year overall survival (OS) rate in the 2015 regimen group (62.3%±6.4% vs 20.6%±6.4%, P=0.001), the 5-year disease-free survival (EFS) rate (61.0%±6.4% vs 21.0% ±6.4% , P=0.001) were better than those in the 2006 regimen group. The 5-year OS and EFS of high-risk transplant patients in the 2015 regimen group were significantly better than those of high-risk non-transplant patients (OS: 86.6%±9.0% vs 26.7%±11.4%, P=0.000; EFS: 86.6%±9% vs 26.7%±11.4%, P=0.000).
Conclusion: The 2015 regimen can increase the CR rate after 2 courses of induction compared with the 2006 regimen. High-risk children receiving hematopoietic stem cell transplantation can significantly improve the prognosis.
题目: CCLG-AML-2015方案治疗儿童急性髓系白血病的临床分析.
目的: 分析CCLG-AML-2015方案治疗初诊儿童急性髓系白血病（AML）的临床效果.
方法: 总结2015年8月至2019年9月武汉儿童医院血液肿瘤科60例初诊AML患儿的临床资料，回顾性分析使用CCLG-AML-2015方案（以下简称2015方案）化疗的效果，对照组为本中心2010年2月-2015年7月使用AML-2006方案（以下简称2006方案）治疗的42例AML患儿.
结果: 2015方案组与2006方案组患者在性别、初诊年龄、危险度分层均无统计学差异（P＞0.05）。2015方案组诱导1个疗程化疗后骨髓细胞学完全缓解率（CR，84.7% vs 73.1%，P=0.155）、微小残留病灶检测（MRD）阴性（42.3% vs 41.4%，P=0.928）与 2006方案组比较无统计学差异，诱导2个疗程后骨髓细胞学CR（98.1% vs 80.6%，P=0.004）及MRD阴性（83.3% vs 52.8%，P=0.002）高于AML-2006方案组。2015方案组5年总生存（OS）率（62.3%±6.4% vs 20.6%±6.4%，P=0.001），5 年无病生存（EFS）率（61.0%±6.4% vs 21.0%±6.4%，P=0.001）均优于2006方案组。2015方案组高危患儿接受移植5年OS、EFS均明显优于高危非移植患儿（86.6%±9.0% vs 26.7%±11.4%，P=0.000；86.6%±9% vs 26.7%±11.4%，P=0.000）.
结论: 2015方案较2006方案可提高诱导2个疗程后CR率，高危患儿接受造血干细胞移植可显著改善预后.
Keywords: CCLG-AML-2015; acute myeloid leukemia; hematopoietic stem cell transplantation; pediatric; prognosis; protocol.