HUANG Tingting,WANG Juxiang,ZHOU Haixia, et al. Long-term outcome of childhood acute lymphoblastic leukemia treated with Chinese Children’s Leukemia Group in China-Acute Lymphoblastic Leukemia 2014[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2021, 51(11): 891-895.
Abstract：Objective: To analyze the long-term efficacy in childhood acute lymphoblastic leukemia cases enrolled in Chinese Children’s Leukemia Group in China-Acute Lymphablastic Leukemia (CCLG-ALL) 2014.Methods: Clinical data of 108 patients diagnosed as ALL and treated with CCLG-ALL2014 protocol between January 2015 and December 2019 in the Department of Hematology-Oncology, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University were retrospectively analyzed. The relationship between minimal residual disease (MRD) monitored by flow cytometry and prognosis was analyzed, and Kaplan-Meier method was applied for long-term survival analysis. Results: A total of 108 patients with newly diagnosed ALL included 55 males and 53 females with a mean aged of 5.3 years (ranging from 1.0 to 15.2) years and a follow-up period of 3.3 years (ranging from 1.0-5.9). Totally 107 patients (99%) achieved complete remission. The 3-year event free survival (EFS) and overall survival (OS) rates was (73.4±4.3)% and (92.9±2.6)%, respectively.Relapse occurred in 10 cases, and 7 patients died. The 3-year OS rate of patients with relapsed disease was significantly worse than those without (50±15.8)% vs. (98.4±1.6)%, χ2=44.884, P<0.001). The 3-year OS rate of patients with MRD>5% on day 15 of induction therapy was significantly worse than those with MRD≤5%[(79.9±8.3)% vs. (98.7±1.3)%, χ2=10.547, P=0.001]. The 3-year OS rate was obviously lower in patients with MRD>10% on day 33 of induction therapy. Conclusion: CCLG-ALL2014 protocol is effective for childhood ALL. The accurate risk stratification guided by MRD and individualized treatment can reduce the relapse and improve the long-term survival rate of pediatric ALL.
