■病因病理学的澄清,化疗方案的改进及其风险分层,过去几年,治疗支持的改善提高了受急性淋巴细胞白血病(ALL)影响的儿童和青少年的生存率.本研究旨在评估巴西血液学治疗中心的总生存率(OS)和无事件生存率(EFS)。报告诊断时患者的主要临床实验室特征,验证治疗相关不良反应的频率和主要死亡原因。
■涉及诊断为ALL的患者的回顾性分析,用巴西儿童白血病治疗组(GBTLI)的方案治疗,在2010年至2020年之间进行;结果(复发,死亡,新肿瘤的发展)进行分析,使用SPSS®软件进行统计分析,当所有分析的p值小于0.05时,p值被认为是显著的。
■109名患者被纳入研究;中位年龄为5岁,男性占主导地位。66例患者被归类为高风险(HR)组,43例患者被归类为低风险(LR)组。经过5年的诊断,操作系统为71.5%,EFS为65%。OS和EFS的HR和LR组间无统计学差异,而白细胞计数与死亡结果在统计学上相关(p=0.028)。在患者中,28人(25.6%)因感染死亡,占死亡原因的46.4%。在34例不良结局(死亡和/或复发)患者中,32在缓解诱导结束时没有研究微小残留病,和25没有调查染色体异常的存在。报告最多的并发症和治疗相关的不良反应是肝转氨酶升高(85.9%),气道感染(79.4%),口腔粘膜炎(67.2%),发热性中性粒细胞减少症(64.4%),腹泻(36.4%)。
■在该队列中获得的OS和EFS的比率与在巴西之前的几次类似研究中获得的比率相似,低于在发达国家进行的比率。无法获得预后测试可能会阻碍风险分层并影响获得的结果。
UNASSIGNED: The clarification of etiopathology, the improvement of chemotherapy regimens and their risk stratifications, and the improvement in treatment support have increased the survival of children and adolescents affected by Acute Lymphoblastic Leukemia (ALL) past few years. This study aimed to estimate overall survival (OS) and event-free survival (EFS) in an onco-hematology treatment center in Brazil, reports the main clinical-laboratory characteristics of patients at diagnosis, verify the frequency of treatment-related adverse effects and the main causes of death.
UNASSIGNED: Retrospective analysis involving patients diagnosed with ALL, treated with the protocol of the Brazilian Group for Treatment of Leukemias in Childhood (GBTLI), between 2010 and 2020 was carried out; the outcomes (relapse, deaths, development of new neoplasms) were analyzed SPSS® software was used for the statistical analyses, and the p-value was considered significant when less than 0.05 for all analyses.
UNASSIGNED: 109 patients were included in the study; the median age was 5 years, with a slight predominance of males. Sixty-six patients were classified as high-risk (HR) group and 43 patients were classified as low-risk (LR) group. After 5 years of diagnosis, the OS was 71.5%, and the EFS was 65%. No statistical difference was found between the HR and LR groups for OS and EFS, while leukocyte counts were statistically associated with the outcome of death (p = 0.028). Among the patients, 28 (25.6%) died due to infection accounting 46.4% of death causes. Among the 34 patients with unfavorable outcomes (death and/or relapse), 32 had no research for the minimal residual disease at the end of remission induction, and 25 were not investigated for the presence of chromosomal abnormalities. The most reported complications and treatment-related adverse effects were increased liver transaminases (85.9%), airway infection (79.4%), oral mucositis (67.2%), febrile neutropenia (64.4%), and diarrhea (36.4%).
UNASSIGNED: The rates of OS and EFS obtained in this cohort are similar to those obtained in the few previous similar studies in Brazil and lower than those carried out in developed countries. The unavailability of prognostic tests may have hindered risk stratification and influenced the results obtained.