中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2009年
3期
186-191
,共6页
李巍%秘营昌%王迎%傅明伟%林冬%王慧君%刘旭萍%卞寿庚%王建祥
李巍%祕營昌%王迎%傅明偉%林鼕%王慧君%劉旭萍%卞壽庚%王建祥
리외%비영창%왕영%부명위%림동%왕혜군%류욱평%변수경%왕건상
白血病,非淋巴细胞,急性%遗传%治疗%预后
白血病,非淋巴細胞,急性%遺傳%治療%預後
백혈병,비림파세포,급성%유전%치료%예후
Leukemia,nonlymphacytic,acute%Translocation,genetic%Therapy%Outcome
目的 探讨影响急性髓系白血病伴t(8;21)患者生存、预后的主要因素.方法 对87例急性髓系白血病伴t(8;21)患者进行总结分析、随访,了解临床一般情况、免疫分型、染色体核型及治疗、生存情况,分析影响总生存(0s)、无复发生存(RFS)的因素.结果 86例完成诱导治疗的急性髓系白血病伴t(8;21)患者总完全缓解(CR)率95.3%,1个疗程CR率69.8%;采用含中剂量阿糖胞苷(Ara-C)方案诱导治疗的患者1个疗程CR率达86.2%,标准剂量Ara-C方案诱导治疗的患者1个疗程CR率60.3%.87例患者的中位OS期为16.4(0.3～121.5)个月,中位RFS期为11.7(1.9～116.3)个月;3年OS率42%,5年OS率39%,3年RFS率55%,5年RFS率55%.统计学分析显示,性别、染色体核型与OS有关,其中男性患者、染色体核型伴9q-的患者预后差、生存期短;诱导缓解治疗方案、巩固治疗方案、巩固治疗疗程数亦与OS有相关性,其中采用中剂量Ara-C诱导治疗、2个疗程以上中剂量Ara-C巩固治疗、完成4个疗程以上巩固治疗的患者预后好、生存期长.结论 性别、染色体核型、诱导缓解及巩固治疗的方案是影响生存、预后的主要因素,在诱导、巩固治疗中应用中剂量Ara-C.可以明显提高1个疗程缓解率,延长OS、RFS期.
目的 探討影響急性髓繫白血病伴t(8;21)患者生存、預後的主要因素.方法 對87例急性髓繫白血病伴t(8;21)患者進行總結分析、隨訪,瞭解臨床一般情況、免疫分型、染色體覈型及治療、生存情況,分析影響總生存(0s)、無複髮生存(RFS)的因素.結果 86例完成誘導治療的急性髓繫白血病伴t(8;21)患者總完全緩解(CR)率95.3%,1箇療程CR率69.8%;採用含中劑量阿糖胞苷(Ara-C)方案誘導治療的患者1箇療程CR率達86.2%,標準劑量Ara-C方案誘導治療的患者1箇療程CR率60.3%.87例患者的中位OS期為16.4(0.3～121.5)箇月,中位RFS期為11.7(1.9～116.3)箇月;3年OS率42%,5年OS率39%,3年RFS率55%,5年RFS率55%.統計學分析顯示,性彆、染色體覈型與OS有關,其中男性患者、染色體覈型伴9q-的患者預後差、生存期短;誘導緩解治療方案、鞏固治療方案、鞏固治療療程數亦與OS有相關性,其中採用中劑量Ara-C誘導治療、2箇療程以上中劑量Ara-C鞏固治療、完成4箇療程以上鞏固治療的患者預後好、生存期長.結論 性彆、染色體覈型、誘導緩解及鞏固治療的方案是影響生存、預後的主要因素,在誘導、鞏固治療中應用中劑量Ara-C.可以明顯提高1箇療程緩解率,延長OS、RFS期.
목적 탐토영향급성수계백혈병반t(8;21)환자생존、예후적주요인소.방법 대87례급성수계백혈병반t(8;21)환자진행총결분석、수방,료해림상일반정황、면역분형、염색체핵형급치료、생존정황,분석영향총생존(0s)、무복발생존(RFS)적인소.결과 86례완성유도치료적급성수계백혈병반t(8;21)환자총완전완해(CR)솔95.3%,1개료정CR솔69.8%;채용함중제량아당포감(Ara-C)방안유도치료적환자1개료정CR솔체86.2%,표준제량Ara-C방안유도치료적환자1개료정CR솔60.3%.87례환자적중위OS기위16.4(0.3～121.5)개월,중위RFS기위11.7(1.9～116.3)개월;3년OS솔42%,5년OS솔39%,3년RFS솔55%,5년RFS솔55%.통계학분석현시,성별、염색체핵형여OS유관,기중남성환자、염색체핵형반9q-적환자예후차、생존기단;유도완해치료방안、공고치료방안、공고치료료정수역여OS유상관성,기중채용중제량Ara-C유도치료、2개료정이상중제량Ara-C공고치료、완성4개료정이상공고치료적환자예후호、생존기장.결론 성별、염색체핵형、유도완해급공고치료적방안시영향생존、예후적주요인소,재유도、공고치료중응용중제량Ara-C.가이명현제고1개료정완해솔,연장OS、RFS기.
Objective To investigate the influence factors on survival and outcome of acute myeloid leukemia(AML)patients with t(8;21).Methods Eishty seven AML patients with t(8;21)after long-term follow-up were enrolled in the analysis of clinical feature,immunophenotype,chromogome karyotype,treatment regimen.as well as the overall survival(OS)and relapse-free survival(RFS).Results The overall complete remssion(CR)rate WaS 95.3%.CR rate after first course therapy was 69.8%.after first course therapy containing medium dose Ara-C was 86.2%.and after first course of therapy containing standard-dose Ara-C was 60.3%.The medion OS duration was 16.4 months,median RFS 11.7 months.3 year OS rate 42%,5 year OS rate 39%,3 year RFS rate 55%and 5 year RFS rate 55%.Male gender chromsome 9q-had statistical significance for shorter OS and poor outcome.2 courses of post-remission thempy with intermediate dose Ara-C.induction theray with intermediate-dose Ara-C and post-remission with 4 courses consolidation therapy had statistically longer OS and RFS.Conclusion Sex,chromosome karyotype,induction and consolidation therapy were important intluence factors on OS and RFS.Application of intermedlate dose Ara-C to induction and consolidation therapy leads to a higher CR rate.prolong OS and RFS.
