文章：

儿童急性淋巴细胞白血病并发急性胰腺炎（AcuPA研究）：波兰全国性调查

Acute Pancreatitis in Pediatric Acute Lymphoblastic Leukemia (AcuPA Study): A Nationwide Survey in Poland

原文发布日期：24 July 2024

DOI: 10.3390/cancers16152640

类型: Article

开放获取: 是

英文摘要：

Purpose: This study aimed to identify the risk factors for acute pancreatitis (AP) and its impact on outcomes in Polish children treated for ALL. Methods: The study group included 2303 children receiving intensive chemotherapy for ALL. The group was divided into patients with at least one episode of AP and those who did not develop AP after treatment for ALL. Results: The cumulative incidence of AP in the study group was 4.08%. Older age was an independent risk factor for the development of AP (OR = 1.05; 95%CI = 1.006–1.098;p= 0.03). The overall mortality associated with AP was 2.13%. The probabilities of disease-free survival (p-DFS) and event-free survival (p-EFS) in both subgroups were 0.84 vs. 0.86, log-rankp= 0.65 and 0.75 vs. 0.80, log-rankp= 0.12, respectively. A total of 22 out of 94 patients (23.4%) with AP were re-exposed to asparaginase (ASP) during the subsequent treatment phases. Only one patient re-exposed to ASP (4.5%) developed a second episode of AP. There were no significant differences in p-DFS and p-EFS between patients re-exposed and not re-exposed to asparaginase (0.78 vs. 0.86, log-rankp= 0.27 and 0.63 vs. 0.79, log-rankp= 0.09, respectively). Conclusions: The incidence of AP in children with ALL is low and related to patients’ age. The development of AP does not seem to influence p-DFS and p-EFS in children with ALL. Recurrence of AP after re-exposure to asparaginase in patients with ALL and a history of AP is low (4.5%). Re-exposure to asparaginase after the first episode of AP does not improve either p-DFS or p-EFS in children with ALL.

摘要翻译： 

目的：本研究旨在确定波兰急性淋巴细胞白血病（ALL）患儿发生急性胰腺炎（AP）的危险因素及其对预后的影响。方法：研究组纳入2303例接受强化化疗的ALL患儿。根据是否发生AP，将患儿分为至少发生过一次AP的组别和未发生AP的组别。结果：研究组中AP的累积发生率为4.08%。年龄较大是发生AP的独立危险因素（OR = 1.05；95%CI = 1.006–1.098；p= 0.03）。与AP相关的总死亡率为2.13%。两个亚组的无病生存率（p-DFS）和无事件生存率（p-EFS）分别为0.84比0.86（log-rank检验p= 0.65）和0.75比0.80（log-rank检验p= 0.12）。94例AP患者中，共有22例（23.4%）在后续治疗阶段再次接受了门冬酰胺酶（ASP）治疗。再次接受ASP治疗的患者中仅有1例（4.5%）出现第二次AP发作。再次接受与未再次接受门冬酰胺酶治疗的患者在p-DFS和p-EFS方面无显著差异（分别为0.78比0.86，log-rank检验p= 0.27；0.63比0.79，log-rank检验p= 0.09）。结论：ALL患儿AP发生率较低，且与患者年龄相关。AP的发生似乎不影响ALL患儿的p-DFS和p-EFS。有AP病史的ALL患儿再次暴露于门冬酰胺酶后AP复发率较低（4.5%）。首次AP发作后再次使用门冬酰胺酶并未改善ALL患儿的p-DFS或p-EFS。

原文链接：

Acute Pancreatitis in Pediatric Acute Lymphoblastic Leukemia (AcuPA Study): A Nationwide Survey in Poland