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題名 | Childhood Non-Hodgkin's Lymphoma--Results of Treatment with ALL High-Risk Protocol=兒童非霍金氏淋巴瘤--以白血病高危險群方案治療之結果 |
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作 者 | 朱惠瑜; 劉錦理; 徐山靜; 遲景上; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 34:2 民82.03-04 |
頁次 | 頁118-124 |
分類號 | 417.554 |
關鍵詞 | 白血病; 兒童; 非霍金氏; 淋巴瘤; |
語文 | 英文(English) |
中文摘要 | 從1984年八月至1990年九月,在台中榮總小兒科,共有十三位非霍金氏淋巴瘤的病童,接受白血病高危險群治療方案之化學治療。這些病童皆經由病理切片證實,其中九例為淋巴芽球型淋巴瘤,三例為組織球型淋巴瘤,一例為未分化型淋巴瘤。經由臨床及實驗室評估後,有八例屬於第四期,四例屬於第三期,一例為第二期。經過該治療方案治療後,十三例中共九例獲得完全緩解,佔69.2%,長期存活率(平均三十六個月)為46.2%。九例淋巴芽球型淋巴瘤的病人則有七人得到完全緩解,六人長期存活。在無法緩解的四個病人中,兩例是因為導入期完成前因出現嚴重感染,家長不願再接受化學治療,其他二例則是治療失敗。一個病人有復發的現象。在藥物副作用方面,中性球過低合併發燒最多見,大約一半的機會可以找到病菌,並無病人因感染而死亡。其他嚴重的併發症包括口腔黏膜嚴重糜爛、腸胃道出血、因L-天門冬素引起之顱內血管栓塞及急性腫瘤溶解症候群。由於兒童之非霍金氏淋巴瘤在病理組織方面多為瀰漫性,同時在診斷時多為後期。選擇一個理想的治療方案非常重要,以便達到最好的治療結果。 |
英文摘要 | Between August 1984 and September 1990, 13 children with non-Hodg kin's lymphoma (NHL) were treated with ALL high-risk protocol (5 with TCLSG 842 regimen and 8 with TPOG 882B protocol) at Taichung Veterans General Hospital. Diagnosis of NHL was confirmed by histology. Nine had lymphoblastic lymphoma, three had histiocytic lymphoma and one had small non-cleaved cell lymphoma, according to the Rappaport classification. After thorough clinical evaluation eight children were NHL stage IV; four were stage Ⅲ; and one was stage Ⅱ. All these children had received chemotherapy as acute lymphocytic leukemia (ALL) high-risk protocol for a total of three years, including central nervous system (CNS) prophylaxis. Of the 13 patients, 9 (69.2%) gained complete remission. Over-all survival rate was 46.2%, with a median interval of 36 months. The complete remission rate and survival rate for the nine children with lymphoblastic lymphoma was better at 77.7% & 66.6% respectively. Within the nonresponsive group, two failed to remit because of early withdrawal from the protocol; the other two patients were refratory to treatment. Relapse was noted in one patient. As to the side effects, neutropenic fever was the most common problem encountered (9 occurrences in 13 patients). Other major complications included severe mucositis, massive GI bleeding, intracranial thrombosis induced by 1-asparagi-nase and tumor lysis syndrome. Childhood NHL is often of diffuse types in pathology, and most affected children have advanced diseases at diagnosis. Choosing an optimal treatment protocol is important for good treatment results. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。