Objective: To study the short-term effect of two different re-induction regimens in the treatment of acute lymphoblastic leukemia (ALL) children with bone marrow recurrence.
Methods: A retrospective analysis was performed for 57 ALL children with bone marrow recurrence. According to their treatment regimen, they were divided into two groups: VMDP (vincristine + mitoxantrone + dexamethasone + PEG-asparaginase; n=42) and VIDP (vincristine + idarubicin + dexamethasone + PEG-asparaginase; n=15). The two groups were compared in terms of complete response rate and incidence rate of adverse reactions.
Results: There was no significant difference in complete response rate between the VMDP and VIDP groups (74% vs 73%, P>0.05). All children experienced grade ≥3 hematological adverse events. The VMDP group had a significantly lower chemotherapy-related mortality rate than the VIDP group (P<0.05). There was no significant difference in the incidence rate of infection between the two groups (P>0.05).
Conclusions: For ALL children with bone marrow recurrence, both re-induction regimens can achieve a relatively high complete response rate, and VMDP regimen has a lower chemotherapy-related mortality rate and can thus be used as an option for re-induction in ALL children with bone marrow recurrence.
目的: 回顾性分析两种不同再诱导方案治疗儿童急性淋巴细胞白血病（ALL）骨髓复发的短期疗效。
方法: 回顾性选择57例骨髓复发的ALL患儿为研究对象，根据治疗方案分为VMDP组（长春新碱+米托蒽醌+地塞米松+培门冬酰胺酶，n=42）和VIDP组（长春新碱+去甲氧柔红霉素+地塞米松+培门冬酰胺酶，n=15）。分析比较两组完全缓解率和不良反应发生率。
结果: VMDP组和VIDP组完全缓解率（74% vs 73%）差异无统计学意义（P > 0.05）。所有患儿均发生3级或3级以上的血液学不良事件，VMDP组化疗相关病死率低于VIDP组（P < 0.05）。两组间感染发生率差异无统计学意义（P > 0.05）。
结论: 针对骨髓复发的儿童ALL，VMDP和VIDP再诱导方案均能获得较高的完全缓解率，且VMDP化疗方案引起的相关病死率更低，可作为儿童ALL骨髓复发再诱导方案的选择。