Introduction: The objective of the current study was to determine the survival probabilities of children and adolescents with acute lymphocytic leukemia treated with adapted Berlin–Frankfurt–Münster (BFM) protocols and compare our results with the original BFM reports. Methods: This retrospective study included 695 patients up to 19 years old treated with adapted BFM protocols between 1997 and 2018 in four hospitals in Rio de Janeiro. The 1997–2007 and 2008–2018 cohorts were analyzed separately. Results: More than half of the patients were stratified into the high-risk BFM classification. Overall and event-free survivals were, in the 1997–2007 period, respectively, 88% and 80% (BFM standard risk group—SRG), 75% and 67% (intermediate risk group—IRG), and 48% and 33% (high-risk group—HRG). The corresponding numbers for the 2008–2018 period were 93% and 84% (SRG), 75% and 63% (IRG), and 64% and 57% (HRG). In the second period, both the OS (HR = 0.71,p= 0.011) and EFS (HR = 0.62,p< 0.001) were higher. Except for the intermediate-risk group, the latter results are comparable to the BFM. Conclusion: The BFM protocol adaptations can be safely implemented in developing countries, accounting for local specificities.
引言：本研究旨在评估采用改良柏林-法兰克福-明斯特（BFM）方案治疗的儿童及青少年急性淋巴细胞白血病患者的生存概率，并将结果与原始BFM研究报告进行对比。方法：本回顾性研究纳入1997年至2018年间在里约热内卢四家医院接受改良BFM方案治疗的695例19岁以下患者，将1997-2007年与2008-2018年两个队列进行独立分析。结果：超过半数患者被分层至BFM高风险组。在1997-2007年期间，标准风险组（SRG）总生存率与无事件生存率分别为88%和80%，中危组（IRG）为75%和67%，高危组（HRG）为48%和33%；2008-2018年期间对应数据分别为93%和84%（SRG）、75%和63%（IRG）、64%和57%（HRG）。后期队列的总生存风险比（HR=0.71，p=0.011）与无事件生存风险比（HR=0.62，p<0.001）均显著改善。除中危组外，后期结果与BFM原始报告具有可比性。结论：改良BFM方案在考虑地区特异性的前提下，可在发展中国家安全实施。
肿瘤(癌症)患者之家