Objective To evaluate the prognostic factors in predicting relapse of childhood acute lymphoblastic leukemia (ALL) treated with CCLG-2008 protocol. Methods From December 1st 2008 and December 31st 2012, 358 patients diagnosed with ALL and treated with the CCLG-ALL 2008 protocol were enrolled in this study. All patients were followed up until September 1st, 2015. Prognostic impact of clinical features, response to treatment, biological features were analyzed and multivariate analysis of predicted value was performed by Cox-regression analysis. Results After treatment of CCLG-ALL 2008 protocol, 79 patients suffered from relapse. The relapse rate in the standard-risk, intermediate-risk and the high-risk groups were 13.3%, 17.6%, and 41.3%, respectively (P < 0.05). The number of very early relapse, early relapse and late relapse were 25, 29, 25, respectively, accounting for 31.6%, 36.7%, and 31.6%. The relapse rates in patients in B-ALL with initial leukocyte counts>100×109/L, non-remission in 15th day of induction (M3), the level of minimal residual disease (MRD) on 12w (12w-MRD) >10-4 were signiifcantly higher, their corresponding hazard ratio were 3.17 (1.58 ~ 6.36), 1.87 (1.07 ~ 3.30), and 1.90 (1.12 ~ 3.20), respectively (P < 0.05). Conclusions After treatment with the CCLG-ALL 2008 protocol, a relatively high relapse rate is observed in children with high-risk ALL. High initial leukocyte counts, non-remission in D15-BM and 12w-MRD>10-4 were the independent prognostic factors for childhood B-ALL.%目的：分析CCLG-2008方案治疗儿童急性淋巴细胞白血病（ALL）复发危险因素。方法回顾性分析2008年12月1日至2012年12月31日初诊ALL且使用CCLG-2008方案化疗的358例患儿随访至2015年9月1日的复发情况及相关影响因素。结果随访期间共有79例患儿复发，复发率22.1%，高危组、中危组、标危组的复发率分别为41.3%、17.6%、13.3%，极早期、早期和晚期复发率分别为31.6%、36.7%和31.6%。Cox回归统计显示，初诊白细胞计数>100×109/L、第15天骨髓M3（骨髓涂片中原始+幼稚细胞比例≥25%）、第12周微小残留病灶（MRD）>10-4的患儿复发率高，其相对危险度及95%置信区间分别为3.17（1.58~ 6.36）、1.87（1.07~ 3.30）、1.90（1.12~ 3.20），差异有统计学意义（P < 0.05）。结论高危组CCLG-2008方案患儿复发率高；初诊白细胞计数、第15天骨髓呈现M3、第12周MRD>10-4是影响复发的重要因素。
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