Bước đầu đánh giá hiệu quả điều trị bệnh bạch cầu cấp dòng lympho ở trẻ em với phác đồ có sử dụng Pegaspargase tại bệnh viện Truyền máu Huyết học=Initial evaluation of the effectiveness of treatment of acute lymphologic leukemia in children with protocol using Pegaspargase at Blood Transfusion Hematology hospital

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Tác giả: Thị Thu Ngân Cai, Quốc Nhi Đặng, Nghĩa Huỳnh, Chân Phương Nguyễn, Hưng Tiến Nguyễn, Chí Dũng Phù, Thị Thanh Trúc Võ

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.310-316

Bộ sưu tập: Metadata

ID: 478264

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Bước đầu đánh giá hiệu quả điều trị bệnh bạch cầu cấp dòng lympho ở trẻ em với phác đồ có sử dụng pegaspargase tại Bệnh viện Truyền Máu Huyết Học (BV TMHH). Phương pháp nghiên cứu: Mô tả hàng loạt ca Đối tượng nghiên cứu: bệnh nhi chẩn đoán bạch cầu cầu cấp dòng lympho (BCCDL) đạt lui bệnh sau giai đoạn tấn công với phác đồ có sử dụng pegaspargase tại BV TMHH thỏa các tiêu chuẩn chọn bệnh. Kết quả: Nghiên cứu chúng tôi có 26 bệnh nhân (BN) thoả tiêu chuẩn chọn mẫu và tiêu chuẩn loại trừ. Tuổi trung vị 5,73 tuổi (2-14), tỷ lệ nam/ nữ 1,9/1. Đặc điểm BN lúc nhập viện ghi nhận: bạch cầu (WBC) lúc nhập viện dưới 50 k/ l chiếm tỷ lệ 88,5%, không xâm lấn tinh hoàn, 100% BN không xâm lấn thần kinh trung ương lúc chẩn đoán (CNS1). Đánh giá đáp ứng điều trị ghi nhận 26,9% BN có MRD N8 <
1%, 80% BN đạt MRD N29 đạt mức <
0,01%, tỷ lệ đạt lui bệnh sau giai đoạn tấn công là 96,2%, tỷ lệ tử vong chiếm 3,8%. Tỷ lệ OS-1 năm là 91,7 ± 0,8%, tỷ lệ EFS-1 năm 81,5 ± 11,9%. Biến chứng ghi nhận trong quá trình điều trị có 57,7% BN có giảm Fibrinogen, 23,1% BN sốt nhiễm trùng, viêm tuỵ cấp do thuốc chiếm tỷ lệ 3,8%, viêm gan cấp ghi nhận 3,8%. Tỷ lệ tử vong trong giai đoạn tấn công là 3,8%. Kết luận: Bạch cầu cấp dòng lympho B ở trẻ em điều trị với phác đồ có pegaspargase cho tỷ lệ đáp ứng cao, cải thiện thời gian sống còn.Iinitial evaluation of the effectiveness of treatment of acute lymphologic leukemia in children with protocol using pegaspargase at Blood Transfusion Hematology Hospital. Methods: case series study. Objective: pediatric patient diagnosed with acute B-cell lymphocytic leukemia (BCCDL B) achieved remission after the attack phase with a regimen using pegaspargase at BTH hospital. Result: In our study, there were 26 patients who met the sampling criteria and exclusion criteria. Median age 5.73 years (2-14), male/female ratio 1.9/1. Characteristics of patients at admission recorded: WBC at admission was less than 50 k/μl, accounting for 88.5%, no testicular invasion, 100% of patients had CNS1. Evaluation of treatment response recorded that 26.9% of patients had MRD N8 <
1%, 80% of patients achieved MRD N29 <
0.01%, and the rate of remission after the attack phase was 96.2%. The mortality rate is 3.8%. The OS-1-year rate is , the EFS-1-year rate is . Complications recorded during treatment were 57.7% of patients with decreased Fibrinogen, 23.1% of patients with infectious fever, 3.8% of patients with drug-induced acute pancreatitis, and 3.8% of patients with acute hepatitis. The mortality rate during the induction is 3.8%. Conclusion: Acute B lymphocytic leukemia in children treated with regimens using pegaspargase resulted in high response rates and improved survival time.

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