재발성/불응성 소아 급성림프모구백혈병 환자의 치료 경향 및 성적에 대한 다기관 후향적 관찰 연구A Multicenter Retrospective Analysis on the Treatment Pattern and Outcome in Relapsed/Refractory Childhood Acute Lymphoblastic Leukemia
- Other Titles
- A Multicenter Retrospective Analysis on the Treatment Pattern and Outcome in Relapsed/Refractory Childhood Acute Lymphoblastic Leukemia
- Authors
- 유건희; 정낙균; 조빈; 강형진; 신희영; 임호준; 서종진; 임영탁; 유철주; 김순기; 전인상; 국훈; 구홍회
- Issue Date
- 2017
- Publisher
- 대한소아혈액종양학회
- Keywords
- Childhood; Acute lymphoblastic leukemia; Relapsed; Refractory
- Citation
- Clinical Pediatric Hematology-Oncology, v.24, no.2, pp.101 - 106
- Journal Title
- Clinical Pediatric Hematology-Oncology
- Volume
- 24
- Number
- 2
- Start Page
- 101
- End Page
- 106
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/6776
- DOI
- 10.15264/cpho.2017.24.2.101
- ISSN
- 2233-5250
- Abstract
- Background: Although the overall survival of childhood acute lymphoblastic leukemia (ALL) approaches 85-90%, the prognosis of relapsed or refractory (R/R) ALL is grave. This study aimed to identify the treatment pattern, treatment response, and overall survival of these patients.
Methods: We reviewed data of 64 patients with R/R ALL whose initial diagnosis of ALL had been made between 1 and 21 years of age. Patients who received clofarabine as part of an induction regimen were excluded. Relapsed patients were limited to those who relapsed after ≥2 prior induction regimens. Treatment patterns, response rates, and overall survival were analyzed.
Results: Patients’ median age was 15.0 years (range, 6.0-25.0) at the diagnosis of R/R ALL. The most frequently used agents other than steroid were vincristine (54.0%), cytarabine (44.6%), and idarubicin (36.5%), while L-asparaginase was used in only one patient. The complete remission (CR) and overall response (OR) rates were 38.1 and 42.9%, respectively. Sixteen patients (25.4%) underwent allogeneic hematopoietic stem cell transplantation (HSCT). The 5-year overall survival was 6.7%. The survival of patients with HSCT was significantly higher compared with those without HSCT (35.2% vs 0%, P=0.0097). Among 14 patients who achieved CR or CR without platelet recovery (CRp) before HSCT, the 3-year survival was 46.9%.
Conclusion: The survival of Korean patients with R/R childhood ALL was dismal despite a reasonable CR rate, whereas that of those who received HSCT after CR or CRp was excellent. More treatment options are needed to improve the overall outcome of R/R childhood ALL.
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