Causes of death and treatment-related mortality in newly diagnosed childhood acute lymphoblastic leukemia treatment with Chinese Children's Cancer Group study ALL-2015

被引:5
|
作者
Liu, Kangkang [1 ]
Shao, Jingbo [2 ]
Cai, Jiaoyang [3 ]
Tang, Jingyan [3 ]
Shen, Shuhong [3 ]
Xu, Fengling [4 ]
Ren, Yuanyuan [5 ]
Zhang, Aijun [6 ]
Tian, Xin [7 ]
Lu, Xiaoqian [8 ]
Hu, Shaoyan [9 ]
Hu, Qun [10 ]
Jiang, Hua [11 ]
Zhou, Fen [12 ]
Liang, Changda [13 ]
Leung, Alex Wing Kwan [14 ]
Zhai, Xiaowen [15 ]
Li, Chunfu [16 ]
Fang, Yongjun [17 ]
Wang, Zhenling [18 ]
Wen, Lu [19 ]
Yang, Hui [20 ]
Wang, Ningling [1 ]
Jiang, Hui [2 ]
机构
[1] Anhui Med Univ, Affiliated Hosp 2, Dept Pediat, Hefei, Peoples R China
[2] Shanghai Jiao Tong Univ, Childrens Hosp, Dept Hematol Oncol, Shanghai, Peoples R China
[3] Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Dept Hematol Oncol, Sch Med, Shanghai, Peoples R China
[4] Chongqing Med Univ, Dept Hematol Oncol, Childrens Hosp, Chongqing, Peoples R China
[5] Chinese Acad Med Sci & Peking Union Med Coll, Inst Hematol & Blood Dis Hosp, Dept Pediat, Tianjin, Peoples R China
[6] Shandong Univ, Dept Pediat, Qilu Hosp, Jinan, Peoples R China
[7] Kunming Childrens Hosp, Dept Hematol Oncol, Kunming, Peoples R China
[8] Sichuan Univ, West China Hosp 2, Dept Hematol Oncol, Chengdu, Peoples R China
[9] Soochow Univ, Dept Hematol Oncol, Childrens Hosp, Suzhou, Peoples R China
[10] Huazhong Univ Sci, Technol Tongji Med Coll, Dept Pediat, Tongji Hosp, Wuhan, Peoples R China
[11] Guangzhou Women & Children Hlth Care Ctr, Dept Hematol Oncol, Guangzhou, Peoples R China
[12] Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Pediat, Union Hosp, Wuhan, Peoples R China
[13] Jiangxi Prov Childrens Hosp, Dept Hematol Oncol, Nanchang, Peoples R China
[14] Chinese Univ Hong Kong, Hong Kong Childrens Hosp, Dept Pediat, Hong Kong, Peoples R China
[15] Fudan Univ, Dept Hematol Oncol, Childrens Hosp, Shanghai, Peoples R China
[16] Southern Med Univ, Nanfang Hosp, Dept Pediat, Guangzhou, Peoples R China
[17] Nanjing Med Univ, Nanjing Childrens Hosp, Dept Hematol Oncol, Nanjing, Peoples R China
[18] Qingdao Univ, Dept Pediat, Affiliated Hosp, Qingdao, Peoples R China
[19] Northwest Womens & Childrens Hosp, Dept Hematol Oncol, Xian, Peoples R China
[20] Cent South Univ, Dept Pediat, Xiangya Hosp, Changsha, Hunan, Peoples R China
关键词
Acute lymphoblastic leukemia; Children; Treatment-related mortality; Multi-center study; China; INFECTION-RELATED MORTALITY; ACUTE MYELOID-LEUKEMIA; RISK; RESISTANCE; THERAPY; CURE;
D O I
10.1007/s00277-023-05389-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To investigate the possible risk factors for death at post-treatment in children with acute lymphoblastic leukemia (ALL). A multivariate competing risk analysis was performed to retrospectively analyze the data of children with ALL who died after treatment with CCCG-ALL-2015 in China and to determine the possible risk factors for death at post-treatment in children with ALL. Age at the first diagnosis of & GE;10 years; final risk level of high-risk; D19 minimal residual disease (MRD) (& GE;0.01%) and D46 MRD (& GE;0.01%); genetic abnormalities, such as KMT2A-rearrangement, c-Myc rearrangement, and PDGFRB rearrangement; and the presence of CNS3 (all P values, <0.05) were identified as independent risk factors, whereas the risk level at the first diagnosis of low-risk (LR) and ETV6::RUNX1 positivity was considered as independent protective factors of death in children with ALL. Among the 471 cases of death, 45 cases were treated with CCCG-ALL-2015 only, and 163 (34.61%) were treatment-related, with 62.42% due to severe infections. 55.83% of treatment-related mortality (TRM) occurred in the early phase of treatment (induction phase). TRM has a significant impact on the overall survival of pediatric patients with ALL. Moreover, the CCCG-ALL-2015 regimen has a better safety profile for treating children with ALL, with rates close to those in developed countries (registration number: ChiCTR-IPR-14005706; date of registration: June 4, 2014).
引用
收藏
页码:3431 / 3444
页数:14
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