A comparative study of clinical efficacy and safety between VDPAP and VDLP regimens in the treatment of children with acute lymphoblastic leukemia

Wan Kecheng; Liu Yingjie; Chen Yuanlu; Lin Boyi; Feng Xiaowei

doi:10.3760/j.issn.1673-4777.2025.12.016

Abstract：Objective To compare the clinical efficacy and safety of the VDPAP regimen(vincristine+daunorubicin+pegaspargase+prednisone)and the VDLP regimen(vincristine+daunorubicin+L-asparaginase+prednisone)in the treatment of children with acute lymphoblastic leukemia(ALL).Methods A total of 146 children with ALL who received chemotherapy at Hainan General Hospital from March 2019 to March 2024 were enrolled.They were divided into a control group and an observation group using a random number table,with 73 cases in each group.The control group was treated with the VDLP regimen,while the observation group was treated with the VDPAP regimen.The treatment response rate,blood routine parameters[white blood cell count(WBC),platelet count(PLT),red blood cell count(RBC),and hemoglobin],coagulation function indices[activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin time(PT),and fibrinogen(FIB)],fibrinolytic indices[plasminogen,tissue-type plasminogen activator(t-PA),plasminogen activator inhibitor-1(PAI-1),and fibrin degradation products(FDP)],serum inflammatory factors[interleukin-6(IL-6),IL-8,high-sensitivity C-reactive protein(hs-CRP),and interferon-γ],serum tumor-specific growth factor(TSGF),vascular endothelial growth factor(VEGF),and incidence of adverse reactions were compared between the two groups.Results There was no statistically significant difference in the treatment response rate between the two groups(P＞0.05).After treatment,the levels of PLT,RBC,APTT,t-PA,PAI-1,and interferon-γ in the observation group were significantly higher than those in the control group,while the levels of WBC,FIB,IL-6,IL-8,hs-CRP,TSGF,and VEGF were significantly lower than those in the control group(all P＜0.05).The incidence of allergies in the observation group was significantly lower than that in the control group[1.4％(1/73)vs 11.0％(8/73)](P＜0.05).Conclusion Both the VDLP and VDPAP regimens are effective in the treatment of children with ALL.Compared with the VDLP regimen,the VDPAP regimen can improve blood routine parameters,inhibit the inflammatory response,and downregulate the serum levels of TSGF and VEGF,with higher safety.However,the VDPAP regimen has a more significant impact on the coagulation function and fibrinolytic indices of children with ALL,so clinicians should select an appropriate regimen based on the children's specific conditions.