| Objective: By searching for the correlation study between prednisone induction test and acute lymphoblastic leukemia in childhood,to systematically review prednisone induced test results in the prognosis assessment of acute lymphoblastic leukemia in children.Methods : Based on the established inclusion and exclusion criteria,studies of Prednisone induced test in evaluating the prognosis of childhood acute lymphoblastic leukemia were were electronically searched from January 1990 to November 2016 using Pubmed,Embase,The Cochrane Library,Web of science,Wan Fang,VIP and CNKI database.Two independent researchers browsed literature,extracted data and assessed the risk of bias of studies,Meta-analysis was performed using Rev Men5.3 software.Results: A total of 17 articles were included.Meta analysis showed that after complete prednisone induced test in children,the 5y-EFS and 8y-EFS of Prednisone good response(PGR)were better than that of Prednisone poor response(PPR)[(MD=22.03,95%CI18.87~25.18),P<0.00001 and(MD=27.9,95%CI20.94~34.85),P<0.00001].The continunous complete remissio n rate and recurrence rate in two groups were compared,the continunous complete remission of prednisone good responsive group was high(OR=4.82,95%CI2.81~8.29,P<0.00001)and the recurrence rate was low(OR=0.26,95%CI0.11~0.59,P=0.001),the differences were statistically significan t.The 10-year event-free survival rate and 15-year event-free survival rate in PPR group were significantly lower than those in PGR group[(MD=34.83,95%CI:30.54~39.12,P<0.00 001),(MD=33.82,95%CI:29.22~38.4,P<0.00 001)],and the differences were statistically significant.There were statistical significance in T cell immune typing,the initial WBC(W BC>50×109/L),D19 Bone Marrow(M1,M2),D15 Bone Marrow(M1,M2)an d D33 minimal residual disease of the two groups [(OR=0.22,95%CI:0.12~0.41,P<0.00001),(OR=0.11,95%CI0.08~0.16,P<0.00001),(OR=8.53,95%CI2.85~25.52,P=0.0001),(OR=0.12,95%CI0.03~0.39,P=0.0005),(OR=14.23,95%CI:1.94~104.49,P=0.0 09;OR=0.10,95%CI:0.02~0.41,P=0.002),(OR=3.33,95%CI:2.25~4.94,P<0.00001)].There were no st atistical significance in gender(male),D19 bone marrow(M3)and D15 bo ne marrow(M3)of the two groups[(OR=0.89,95%CI0.62~1.28,P=0.53),(O R=0.24,95%CI0.04~1.44,P=0.12),(OR=0.23,95%CI:0.02~2.83,P=0.25)].There was significant difference in age between PGR group and PPR gr oup(older than 10 years old,the age of 1 to 9 years,under 1 year old)and the meta analysis results show(OR=0.38,95%CI:0.19~0.76,P=0.0 06),(OR=3.04,95%CI:2.23~4.14,P=0.00001)and(OR=0.25,95%CI:0.08~0.74,P=0.01).Conclusion:The prednisone induction test is an important index to evaluate the prognosis of children with ALL,The tre atment of prednisone induced test based on Selection can improve the pr ognosis of children. |
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