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《Chinese Journal of Practical Pediatrics》 2008-02
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The comparisons of outcome and cost of three protocols for childhood non-high-risk acute lymphoblastic leukemia

LUO Xue-qun,GUAN Xiao-qing,LIN Yuan,et al.Department of Pediatric,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China  
Objective To compare the outcome and treatment cost of 3 protocols for childhood non-high-risk acute lymphoblastic leukemia (ALL),and evaluate the possibility of less intensive and lower cost protocol for children with ALL from low income families.Methods Totally 243 children with ALL were diagnosed in a university hospital from May 1999 to September 2006.One of chemotherapy protocols was selected by parents of those with non-high-risk ALL: Rongcheng 98 protocol as suggested by Chinese Pediatric Hematology Group(Group A),IC BFM 2002(Group B) or less intensive and lower cost protocol developed by our department(Group C).Results Among 243 cases,20 abandoned treatment,3 transferred to other hospitals or died after diagnosis,47 were high risk and 4 were mature B-ALL.Of the remained 169 cases,46 selected Group A,73 Group B and 50 from low income families selected Group C.The pEFS(sx) and pDFS(sx) of patients were: in Group A at 4 years,80.4%(0.059) and 82.2%(0.057),at 7 years,78.1%(0.061) and 79.8%(0.060); in Group B at 4 years,83.5%(0.051)and 85.9%(0.049);in group C at 4 years,72.8%(0.069)和74.3%(0.069),at 7 years,67.2%(0.84)和68.6%(0.085),respectively.The costs(Yuan) of inpatient chemotherapy were significantly different between each Group and ranged from(median):65 000~191 000(94 000) in Group A,52 000~123 000(74 000) in Group B and 23 000~51 000(32 000) in Group C,respectively.Conclusion This is the first report in our country systematically reviewing the treatment cost and outcome between different protocols.The less intensive protocol appears to achieve a reasonable EFS and DFS with a much lower cost.This will be especially important in areas with low family income.
【CateGory Index】: R733.7
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