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

作者全名："Liu, Kangkang; Shao, Jingbo; Cai, Jiaoyang; Tang, Jingyan; Shen, Shuhong; Xu, Fengling; Ren, Yuanyuan; Zhang, Aijun; Tian, Xin; Lu, Xiaoqian; Hu, Shaoyan; Hu, Qun; Jiang, Hua; Zhou, Fen; Liang, Changda; Leung, Alex Wing Kwan; Zhai, Xiaowen; Li, Chunfu; Fang, Yongjun; Wang, Zhenling; Wen, Lu; Yang, Hui; Wang, Ningling; Jiang, Hui"

作者地址："[Liu, Kangkang; Wang, Ningling] Anhui Med Univ, Affiliated Hosp 2, Dept Pediat, Hefei, Peoples R China; [Shao, Jingbo; Jiang, Hui] Shanghai Jiao Tong Univ, Childrens Hosp, Dept Hematol Oncol, Shanghai, Peoples R China; [Cai, Jiaoyang; Tang, Jingyan; Shen, Shuhong] Shanghai Jiao Tong Univ, Shanghai Childrens Med Ctr, Dept Hematol Oncol, Sch Med, Shanghai, Peoples R China; [Xu, Fengling] Chongqing Med Univ, Dept Hematol Oncol, Childrens Hosp, Chongqing, Peoples R China; [Ren, Yuanyuan] Chinese Acad Med Sci & Peking Union Med Coll, Inst Hematol & Blood Dis Hosp, Dept Pediat, Tianjin, Peoples R China; [Zhang, Aijun] Shandong Univ, Dept Pediat, Qilu Hosp, Jinan, Peoples R China; [Tian, Xin] Kunming Childrens Hosp, Dept Hematol Oncol, Kunming, Peoples R China; [Lu, Xiaoqian] Sichuan Univ, West China Hosp 2, Dept Hematol Oncol, Chengdu, Peoples R China; [Hu, Shaoyan] Soochow Univ, Dept Hematol Oncol, Childrens Hosp, Suzhou, Peoples R China; [Hu, Qun] Huazhong Univ Sci, Technol Tongji Med Coll, Dept Pediat, Tongji Hosp, Wuhan, Peoples R China; [Jiang, Hua] Guangzhou Women & Children Hlth Care Ctr, Dept Hematol Oncol, Guangzhou, Peoples R China; [Zhou, Fen] Huazhong Univ Sci & Technol, Tongji Med Coll, Dept Pediat, Union Hosp, Wuhan, Peoples R China; [Liang, Changda] Jiangxi Prov Childrens Hosp, Dept Hematol Oncol, Nanchang, Peoples R China; [Leung, Alex Wing Kwan] Chinese Univ Hong Kong, Hong Kong Childrens Hosp, Dept Pediat, Hong Kong, Peoples R China; [Zhai, Xiaowen] Fudan Univ, Dept Hematol Oncol, Childrens Hosp, Shanghai, Peoples R China; [Li, Chunfu] Southern Med Univ, Nanfang Hosp, Dept Pediat, Guangzhou, Peoples R China; [Fang, Yongjun] Nanjing Med Univ, Nanjing Childrens Hosp, Dept Hematol Oncol, Nanjing, Peoples R China; [Wang, Zhenling] Qingdao Univ, Dept Pediat, Affiliated Hosp, Qingdao, Peoples R China; [Wen, Lu] Northwest Womens & Childrens Hosp, Dept Hematol Oncol, Xian, Peoples R China; [Yang, Hui] Cent South Univ, Dept Pediat, Xiangya Hosp, Changsha, Hunan, Peoples R China"

通信作者："Wang, NL (通讯作者)，Anhui Med Univ, Affiliated Hosp 2, Dept Pediat, Hefei, Peoples R China.; Jiang, H (通讯作者)，Shanghai Jiao Tong Univ, Childrens Hosp, Dept Hematol Oncol, Shanghai, Peoples R China."

来源：ANNALS OF HEMATOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001042546300001

JCR分区：Q2

影响因子：3

年份：2023

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期号：　

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文献类型：Article; Early Access

关键词：Acute lymphoblastic leukemia; Children; Treatment-related mortality; Multi-center study; China

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)."

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