Objective: To investigate the efficacy and safety of intensive maintenance chemotherapy regimen for treatment of children and adolescents with lymphoblastic lymphoma at stage Ⅲ-Ⅳ.
Methods: The clinical data of 87 children and adolescents with lymphoblastic lymphoma at stage Ⅲ-Ⅳ were analyzed retrospectively from July 2009 to July 2015. All patients received the treatment of modified NHL-BFM-90/95 regimen, and divided into 2 groups: the control group (62 patients) with conventional maintenance chemotherapy regimen, and the intensive regimen group (25 patients) with intensive maintenance chemotherapy regimen. The event-free survival (EFS) rate and overall survival (OS) rate during follow-up for 5 years, recurrence rate, mortality, and toxic and side effects were compared between 2 groups.
Results: There was no significant difference in the EFS rate and OS rate after follow-up for 5 years between 2 groups (P＞0.05). There was no significant difference in the EFS rate and OS rate after follow-up for 5 years between clinical stage for Ⅲ and Ⅳ, immunotyping for T-LBL and B-LBL and morderate risk and high risk in 2 groups (P＜0.05). There was no significant difference in the recurrence rate and mortality after followed-up between 2 groups (P＞0.05). The incidence of myelosuppression for Ⅲ-Ⅳ grade during maintenance therapy in intensive regimen group were significantly higher than that in control group (P＜0.05).
Conclusion: Compared with conventional maintenance chemotherapy regimen, intensive maintenance chemotherapy regimen in the treatment of children and adolescents with lymphoblastic lymphoma for stage Ⅲ-Ⅳ possess the same survival benefit, but may cause increased severe bone marrow suppression risk.
题目: 强化维持化疗方案治疗Ⅲ-Ⅳ期儿童青少年淋巴母细胞淋巴瘤患者的疗效及安全性.
目的: 探讨强化维持化疗方案治疗Ⅲ-Ⅳ期儿童青少年淋巴母细胞淋巴瘤（LBL）患者的疗效及安全性。方法：回顾性分析本院2009年7月-2015年7月收治的87例Ⅲ-Ⅳ期儿童青少年LBL患者的临床资料。87例患者均采用改良NHL-BFM-90/-95方案治疗，其中62例在维持治疗阶段给予常规化疗方案设为对照组，25例在维持治疗阶段给予强化化疗方案设为强化方案组，比较2组随访5年无事件生存（EFS）率、总生存（OS）率，复发死亡情况及毒副作用发生情况。结果：2组患者随访5年EFS率和OS率比较差异无统计学意义（P＞0.05）；2组临床分期Ⅲ期/Ⅳ期、免疫分型T-LBL/B-LBL及中危/高危组间随访5年EFS率、OS率比较差异无统计学意义（P＞0.05）；2组患者随访复发率和死亡率比较差异无统计学意义（P＞0.05）。强化方案组维持治疗期间Ⅲ-Ⅳ级骨髓抑制发生率显著高于对照组（P＜0.05）。结论：强化维持化疗方案用于Ⅲ-Ⅳ期儿童青少年LBL患者治疗较常规维持化疗方案并未增加生存获益，且可能导致严重骨髓抑制发生风险升高。.
方法: 回顾性分析本院2009年7月-2015年7月收治的87例Ⅲ-Ⅳ期儿童青少年LBL患者的临床资料。87例患者均采用改良NHL-BFM-90/-95方案治疗，其中62例在维持治疗阶段给予常规化疗方案设为对照组，25例在维持治疗阶段给予强化化疗方案设为强化方案组，比较2组随访5年无事件生存（EFS）率、总生存（OS）率，复发死亡情况及毒副作用发生情况.
结果: 2组患者随访5年EFS率和OS率比较差异无统计学意义（P＞0.05）；2组临床分期Ⅲ期/Ⅳ期、免疫分型T-LBL/B-LBL及中危/高危组间随访5年EFS率、OS率比较差异无统计学意义（P＞0.05）；2组患者随访复发率和死亡率比较差异无统计学意义（P＞0.05）。强化方案组维持治疗期间Ⅲ-Ⅳ级骨髓抑制发生率显著高于对照组（P＜0.05）.
结论: 强化维持化疗方案用于Ⅲ-Ⅳ期儿童青少年LBL患者治疗较常规维持化疗方案并未增加生存获益，且可能导致严重骨髓抑制发生风险升高.