Keywords
Abstract
The results of treatment of 368 primary patients with ALL (aged from 1 to 18 years) were analyzed. Of these, 145 received treatment according to the ALL-BFM -95m protocol and 223 children according to the ALL-MB-2008 protocol in the children's department of the Republican Specialized Scientific and Practical Medical Center of Hematology. Clinical, morphological, immunological, molecular genetic research studies of bone marrow and statistical methods for processing the results. The results of therapy of 145 patients according to the ALL-BFM-95m protocol were analyzed. Overall survival (OS) was 48% ± 4% (67 patients). The 10-year disease-free survival (EFS) was 48% ± 4% (67 patients). The cumulative recurrence risk (CIR) was 38% ± 4.1% (53 patients). There were 11.2% ± 2.6% of cases of deaths associated with therapy (TRD) - 16 patients. According to the results of therapy, 223 patients who received treatment according to the ALL_MB-2008 protocol: overall survival (OS) was 75% ± 3% (162 patients). The 10-year relapse-free survival (EFS) was 71% ± 3% (152 patients), the cumulative recurrence risk (CIR) was 16.4% ± 2.5% (36 patients). There were 8.8% ± 1.9% of cases of deaths associated with therapy (TRD) - 19 patients. In a comparative analysis of the results of treatment programs with different intensities of chemotherapy, 10-year relapse-free survival (EFS) according to the All-BFM-95m protocol was 48% ± 4% versus 71% ± 3% according to the ALL-MB-2008 protocol. The percentage of achieving remissions was higher in patients under the ALL-MB-2008 protocol, 95.1% (n = 213) compared to 90.3% under the All-BFM-95m protocol (n = 131, p = 0.0765).
Thus, it is possible to reduce the intensity and toxicity of the chemotherapy performed without reducing the final results of treatment. At the same time, the high intensity of chemotherapy according to the All-BFM-95m protocol was the reason for the high induction mortality.