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ID:38860072
大小:1.40 MB
页数:7页
时间:2019-06-20
《急性髓系白血病预后相关因素分析》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、万方数据自堡逦:鲞旦擅!Q!!堡!旦箜丝鲞箜!塑』!坠望型丛堡!!!坐堕鱼虹E!!坐:!!!坐型垫!i:!!!:丝!盟!:兰急性髓系白血病预后相关因素分析张露露夏海龙【摘要】目的探讨成年急性髓系白血病(AML)患者的预后影响因素。方法回顾性分析182例初治AML患者临床资料,探讨患者性别、年龄(以60岁为界)、初治白细胞计数(/>30×109/L)、骨髓细胞学免疫表型、细胞遗传学、异基因造血干细胞移植(allo—HSCT)和治疗1个疗程获得完全缓解(CR)等因素与总生存(OS)及无事件生存(EFS)的关系。结果182例AML患者的中位年龄49岁(14~80岁
2、),中位随访时间9.7个月(0.5—75.5个月),首次化疗达CR107例,总有效率为65.9%(120/182),年龄>t60岁、CD64阴性、染色体高危组及首次诱导未达CR患者的总CR率低于无上述因素者。单因素生存分析提示年龄≥60岁、细胞遗传学高危组、CDl9阴性、CDllb阳性、CD64阴性、未行allo—HSCT、首次诱导未达到CR的患者OS及EFS较短(P<0.05),多因素分析显示年龄、细胞遗传学表达、CDllb、CD64、是否行allo.HSCT、首次诱导能否达CR是患者OS的独立预后因素,细胞遗传学表达、CD64表达、是否行alIo-HSC
3、T及首次诱导能否达CR是患者EFS的独立预后因素。结论根据AML相关因素进行预后分析判断,有利于临床医生早期制订个体化治疗方案,对于延长患者生存期有重要意义。【关键词】白血病,髓样,急性;原发;预后因素AnalysisonprognosticfactorsofacutemyeloidleukemiaZhongLulu,XiaHailong.DepartmentofHematology,theFirstA庐liatedHospitalofAnhuiMedicalUniversity,Hefei230022,ChinaCorrespondingauthor:Xi
4、aHailong,Email:xhll999cn@163.corn【Abstract】ObjectiveToinvestigatethecorrelatedfactorsofprognosisforacutemyeloidleukemia(AML).MethodsAretrospectiveanalysisofinitial182patientswithAMLwasperformedtoassesstherelationshipbetweenprognosticfactorsincludingsex,age,whitecellcountatdiagnosis
5、,immunophenotype,cytogenetics,allo·HSCTandcompleteremission(CR)afterone—courseofinductionandoverallsurvival(OS)oreventfreesurvival(EFS).ResultsThemedianageof182patientswas49(14-80)yearsold,andthemedianfollowupwas9.7(0.5-75.5)months.Therewere107patientsachievedCRafterone·courseofind
6、uction(totalresponseratewas65。9%,1201182),age>/60years.CD64negative,unfavorablecyto—geneticsandfailingtoachieveCRafterone-courseofinductionwereassociatedwithlowertotalCRrate.Univariateanalysisresultsdemonstratedthatage>160years,unfavorablecytogenetics,CDIlbexpressionandfailingtoach
7、ieveCRafterone—courseofinductionhadpoorinfluenceon3-yearsOSandEFS,whilethe3-yearsOSandEFSforpatientswithCDl9expression,CD64expressionandallo-HSCTwerebetterthanthatofthepatientswithnegativeCDl9andCD64.Multivariateanalysissuggestedthatage,cytogenetics,CDIlb,CD64,allo—HSCTandCRafteron
8、e.courseofinductionwereind
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