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재발성/불응성 소아 급성림프모구백혈병 환자의 치료 경향 및 성적에 대한 다기관 후향적 관찰 연구

Other Titles
 A Multicenter Retrospective Analysis on the Treatment Pattern and Outcome in Relapsed/Refractory Childhood Acute Lymphoblastic Leukemia 
Authors
 Keon Hee Yoo  ;  Nak Gyun Chung  ;  Bin Cho  ;  Hyoung Jin Kang  ;  Hee Young Shin  ;  Ho Joon Im  ;  Jong Jin Seo  ;  Young Tak Lim  ;  Chuhl Joo Lyu  ;  Soon Ki Kim  ;  In-Sang Jeon  ;  Hoon Kook  ;  Hong Hoe Koo 
Citation
 Clinical Pediatric Hematology-Oncology, Vol.24(2) : 101-106, 2017 
Journal Title
 Clinical Pediatric Hematology-Oncology 
ISSN
 2233-5250 
Issue Date
2017
Keywords
Childhood ; Acute lymphoblastic leukemia ; Relapsed ; Refractory
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161473
DOI
10.15264/cpho.2017.24.2.101
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실)
Yonsei Authors
유철주(Lyu, Chuhl Joo)
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