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《急性早幼粒细胞白血病患者诱导治疗中出现分化综合征的多因素分析.pdf》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、中华老年多器官疾病杂志2014年1O月28日第13卷第10期ChinJMultOrganDisElderly,Vo1.13,No.10,Oct28,2014·755-·临床研究·急性早幼粒细胞白血病患者诱导治疗中出现分化综合征的多因素分析马媛媛,沈建良(海军总医院血液科,北京100037)【摘要】目的分析初诊的急性早幼粒细胞白血病(APL)患者在接受全反式维A酸(ATRA)诱导治疗期间出现分化综合征(DS)影响因素。方法收集2005至2014年间海军总医院血液科初诊APL并接受ATRA联合三氧化二砷(ATO)酸或蒽环类药物诱导治疗的84例
2、患者。根据Frankel描述诊断其中35例出现DS。按照潜在危险因素收集数据,对影响DS发生、发展的危险因素进行单因素分析及logistic多因素回归分析。结果logistic多因素回归分析显示,患者初诊时白细胞计数及早幼粒细胞白血病一维A酸受体a(PML.RARa)基因分型是影PADS发生的独立危险因素(尸3、基因分型的长(L)亚型及短(s)亚型行检验分析,结果显示L亚型早幼粒细胞白血病.a纸A酸变体(PML—RARa)基因对Ds的发生有统计学意义(P<0.05o结论初诊时外周血白细胞计数较高的患者及PML.RARa基因为L亚型的患者在初期接受维A酸联合诱导化疗时更易出现DS。【关键词】分化综合征;急性早幼粒细胞白血病;PML.RARa融合基因;危险因素【中图分类号】R733.71【文献标识码】A【DOI】10.3724/SP.J.1264.2014.000174Multivariateanalysisfordifferentiationsyn4、dromeinacutepromyelocyticleukemiapatientsduringinductiontherapyMAYuan—Yuan,SHENJian—Liang(DepartmentofHematology,ChinesePLANavyGeneralHospital,Beijing100037,China)【Abstract】0bjectiveToanalyzethecomprehensiveinfluencingfactorsforoccurrenceofdiferentiationsyndrome(DS)inthep5、atientswithacutepromyelocyticleukemia(APE)undergoinginductiontherapywithall·transretinoicacid(ATRA).MethodsAtotalof84patientswithfreshlydiagnosedAPLandreceivinginductiontreatmentwithATRAincombinationwitharsenictrioxide(ATO)oranthracyclineanticancerdrugsinourdepartmentfrom6、2005to2014wereenrolledinthisstudy.AccordingtothedescriptionofDSbyFrankel,thesubjectsweredividedintoDSgroup(=35)andnon—DS(norma1)group(=51).Datawerecollectedbasedonthepotentialriskfactors.Univariateanalysisandlogisticregressionanalysiswereusedtostudytheriskfactorsfortheocc7、urrenceanddevelopmentofDS.ResultsTheresultsoflogisticregressionanalysisshowedthatwhitebloodcell(WBC)countoninitialdiagnosisandgenotypeofpromyelocyteleukemia—retinoicacidreceptoralpharPML—RARa)wereindependentriskfactorsforDSinAPLpatientsr尸<0.05).Thenchi—squareanalysiswasca8、rriedoutonthese2itemstoexcludethemutualinfluenceamongmultiplefactors.Theresultsindicatedthatther
3、基因分型的长(L)亚型及短(s)亚型行检验分析,结果显示L亚型早幼粒细胞白血病.a纸A酸变体(PML—RARa)基因对Ds的发生有统计学意义(P<0.05o结论初诊时外周血白细胞计数较高的患者及PML.RARa基因为L亚型的患者在初期接受维A酸联合诱导化疗时更易出现DS。【关键词】分化综合征;急性早幼粒细胞白血病;PML.RARa融合基因;危险因素【中图分类号】R733.71【文献标识码】A【DOI】10.3724/SP.J.1264.2014.000174Multivariateanalysisfordifferentiationsyn
4、dromeinacutepromyelocyticleukemiapatientsduringinductiontherapyMAYuan—Yuan,SHENJian—Liang(DepartmentofHematology,ChinesePLANavyGeneralHospital,Beijing100037,China)【Abstract】0bjectiveToanalyzethecomprehensiveinfluencingfactorsforoccurrenceofdiferentiationsyndrome(DS)inthep
5、atientswithacutepromyelocyticleukemia(APE)undergoinginductiontherapywithall·transretinoicacid(ATRA).MethodsAtotalof84patientswithfreshlydiagnosedAPLandreceivinginductiontreatmentwithATRAincombinationwitharsenictrioxide(ATO)oranthracyclineanticancerdrugsinourdepartmentfrom
6、2005to2014wereenrolledinthisstudy.AccordingtothedescriptionofDSbyFrankel,thesubjectsweredividedintoDSgroup(=35)andnon—DS(norma1)group(=51).Datawerecollectedbasedonthepotentialriskfactors.Univariateanalysisandlogisticregressionanalysiswereusedtostudytheriskfactorsfortheocc
7、urrenceanddevelopmentofDS.ResultsTheresultsoflogisticregressionanalysisshowedthatwhitebloodcell(WBC)countoninitialdiagnosisandgenotypeofpromyelocyteleukemia—retinoicacidreceptoralpharPML—RARa)wereindependentriskfactorsforDSinAPLpatientsr尸<0.05).Thenchi—squareanalysiswasca
8、rriedoutonthese2itemstoexcludethemutualinfluenceamongmultiplefactors.Theresultsindicatedthatther
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