CAJ | 학술논문

目的探讨老年急性髓系白血病(AML)诱导缓解化疗的疗效及预后.方法回顾性分析2003年1月至2010年7月收治的156例年龄≥60岁AML患者的临床资料,其中104例接受以阿糖胞苷为基础的诱导缓解化疗方案,包括DA方案、IA方案、CAG方案,52例接受姑息治疗.比较接受诱导缓解化疗与姑息治疗患者的预后差异,并对患者预后因素进行单因素和多因素分析.结果 145例(93％)患者获得随访,其中接受诱导缓解化疗组96例,姑息治疗组49例,中位生存期分别为316 d和37 d,两者差异具有统计学意义(P＜0.01).未接受诱导缓解化疗、入院时白细胞计数高(≥100×109/L)、高危核型、Charlson合并症指数(CCI)评分≥2均是影响预后的独立危险因素.结论诱导缓解化疗可改善老年AML患者的预后,延长中位生存期.未接受诱导缓解化疗、具有高白细胞计数(≥100×109/L)、高危核型、CCI评分≥2的患者预后不良.
목적 탐토노년급성수계백혈병(AML)유도완해화료적료효급예후.방법 회고성분석2003년1월지2010년7월수치적156례년령≥60세AML환자적림상자료,기중104례접수이아당포감위기출적유도완해화료방안,포괄DA방안、IA방안、CAG방안,52례접수고식치료.비교접수유도완해화료여고식치료환자적예후차이,병대환자예후인소진행단인소화다인소분석.결과 145례(93％)환자획득수방,기중접수유도완해화료조96례,고식치료조49례,중위생존기분별위316 d화37 d,량자차이구유통계학의의(P＜0.01).미접수유도완해화료、입원시백세포계수고(≥100×109/L)、고위핵형、Charlson합병증지수(CCI)평분≥2균시영향예후적독립위험인소.결론 유도완해화료가개선노년AML환자적예후,연장중위생존기.미접수유도완해화료、구유고백세포계수(≥100×109/L)、고위핵형、CCI평분≥2적환자예후불량.
Objective To explore the outcome of remission induction chemotherapy (IC) and prognotic anagsis in elderly patients with acute myeloid leukemia (AML).Methods The clinical data of 156 AML patients older than 60 years in the Institute of Hematology,Union Hospital of Fujian Medical University from January 2003 to July 2010 were analyzed retrospectively.104 patients received cytarabine-based regimens,including protocol DA,IA or CAG,while 52 patients received palliative treatment.The median survival time was compared between patients with and without IC.The prognostic factors were evaluated by using univariate and multivariate analyses.Results 145 (93％) cases were followed-up.The median survival time was 316 days in 96 IC patients,compared with 37 days in 49 PT patients (P ＜0.01 ).Not receiving induction chemotherapy,high-risk karyotype,hyperleukocytosis ( ≥ 100 × 109/L),Charlson Comorbidity Index (CCI) ≥2 were adverse prognostic factors of the survival time with univariate analysis,and all were independent poor factors affecting the survival time with multivariate analysis.Conclusions IC can improve outcomes in elderly AML patients.The patients with hyperleukocytosis( ≥ 100 × 109/L),high-risk karyotype,CCI≥2 and without receiving IC have poorer prognosis.