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Evaluation of long-term therapeutic effects of children with T cell acute lymphoblastic leukemia of multiple medical centers and the follow-up report

TANG Meng-jie1,YUAN Xiao-jun1, TANG Jing-yan2, SHEN Shu-hong2, SUN Li-rong3, JIANG Hui4, WANG Ning-ling5   

  1. 1.Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; 2.Department of Pediatric Hematology/Oncology, Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 3.Department of Pediatrics, the Affiliated Hospital of Qingdao University, Qingdao 266003, China; 4.Department of Pediatric Hematology, Children’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200040, China; 5.Department of Pediatrics, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
  • Online:2014-11-28 Published:2014-12-02
  • Supported by:

    InnovationProgramofShanghaiMunicipalEducationCommittee, 09ZZ115

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Abstract:

Objective To evaluate the clinical effects of ALL-2005 protocol on children with T lymphocyte acute lymphoblastic leukemia (T-ALL). Methods Clinical data of 53 patients with T-ALL from five Children's Medical Centers of Hematology/Oncology between 1st May 2005 and 30th September 2009 were selected and treated by the ALL-2005 protocol. All patients underwent the chemotherapy of different dose intensity according to their risk levels (medium risk or high risk). The remission rate of induction, complications relevant to the treatment, and follow-up results were retrospectively analyzed. Factors influencing the prognosis of T-ALL were analyzed by the Kaplan-Meier survival analysis. Results Among 52 patients (excluding one patient who died of disseminated intravascular coagulation two days after diagnosis), 44 of them were males and 8 were females. The median age of diagnosis was 8.1 years old and 16 cases (19.2%) were over 10 years old. The white blood cell count of 35 patients (67.3%) was higher than or equal to 50×109/L. The remission rate of induction was 88.5% on the 35th day after treatment. Seven cases (13.5%) relapsed and the median relapse time was 8.3 months. Among 7 cases, 4 cases suffered from bone marrow relapse and 3 cases suffered from central nervous system relapse. The median follow-up time was 62.0 months. The 8-year overall survival rates of all patients, medium risk group, and high risk group were (82.6±5.2)%, (91.1±3.2)% and (51.5±13.7)%. The difference of two groups was statistically significant (P<0.000 1). The 8-year event-free survival rates of all patients, medium risk group, and high risk group were (68.4±6.1)%, (74.6±5.8)%, and (36.9±12.9)%. The difference of two groups was statistically significant (P<0.0001). Conclusion ALL-2005 protocol achieves good clinical outcome for children with T-ALL. Complete remission during the induction period and risk-based grouping are independent factors that influence the prognosis of T-ALL.

Key words: leukemia, T lymphocyte, children, combination chemotherapy, multi-center