中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2010年
1期
6-10
,共5页
李巍%秘营昌%王迎%林冬%魏辉%刘旭萍%卞寿庚%王建祥
李巍%祕營昌%王迎%林鼕%魏輝%劉旭萍%卞壽庚%王建祥
리외%비영창%왕영%림동%위휘%류욱평%변수경%왕건상
白血病%核型分析%治疗结果%预后
白血病%覈型分析%治療結果%預後
백혈병%핵형분석%치료결과%예후
Leukemia,myeloid,acute%Karyotype analysis%Therapy result%Prognosis
目的 探讨影响急性髓系白血病(AML)-M_4型患者生存、预后的主要因素.方法 70例AML-M_4患者分为二组:①伴嗜酸粒细胞比例增高但不伴有inv(16)[Eos~+inv(16)~-]组;②嗜酸粒细胞比例增高伴有inv(16)[Eos~+inv(16)~+]组;③不伴有嗜酸粒细胞比例增高(Eos~-)组.总结分析患者临床表现、免疫分型、染色体核型及生存情况,分析影响总体生存(OS)时间、尢复发生存(RFS)时间的因素.结果 70例AML-M_4患者完全缓解(CR)率85.7%,其中1个疗程CR率71.4%;所有患者的中位OS期为20.0(1.2～162.4)个月,达CR患者的中位RFS期为78.0(1.2～129.5)个月;3年、5年OS率分别为42%、42%,3年、5年RFS率分别为59%、54%.Eos组总体CR率76.9%,1个疗程CR率61.5%,中位OS期为11.2个月,中位RFS期为10.8个月;Eos~+组总体CR率96.8%,1个疗程CR率89.6%,中位OS、RFS期未达.统汁学分析表明,两组在总体CR率、OS和RFS期差异均有统计学意义.Eos~+组内分析表明,Eos~+inv(16)~+组总体CR率达100%,1个疗程CR率达94.4%,中位OS、RFS期未达;Eos~+inv(16)~-组总体CR率达91.7%,1个疗程CR率达69.2%,中位OS期为14.3个月,中位RFS期为12.4个月.统汁学分析表明,Eos~+inv(16)~+组、Eos~+inv(16)~-组OS、RFS期差异均有统计学意义.结论单独伴有Eos比例升高可作为AML-M_4患者预后良好因素之一,其中Eos~+inv(16)~+组预后最好.Eos~+组患者具有发病年龄较小、血小板计数低的特点.
目的 探討影響急性髓繫白血病(AML)-M_4型患者生存、預後的主要因素.方法 70例AML-M_4患者分為二組:①伴嗜痠粒細胞比例增高但不伴有inv(16)[Eos~+inv(16)~-]組;②嗜痠粒細胞比例增高伴有inv(16)[Eos~+inv(16)~+]組;③不伴有嗜痠粒細胞比例增高(Eos~-)組.總結分析患者臨床錶現、免疫分型、染色體覈型及生存情況,分析影響總體生存(OS)時間、尢複髮生存(RFS)時間的因素.結果 70例AML-M_4患者完全緩解(CR)率85.7%,其中1箇療程CR率71.4%;所有患者的中位OS期為20.0(1.2～162.4)箇月,達CR患者的中位RFS期為78.0(1.2～129.5)箇月;3年、5年OS率分彆為42%、42%,3年、5年RFS率分彆為59%、54%.Eos組總體CR率76.9%,1箇療程CR率61.5%,中位OS期為11.2箇月,中位RFS期為10.8箇月;Eos~+組總體CR率96.8%,1箇療程CR率89.6%,中位OS、RFS期未達.統汁學分析錶明,兩組在總體CR率、OS和RFS期差異均有統計學意義.Eos~+組內分析錶明,Eos~+inv(16)~+組總體CR率達100%,1箇療程CR率達94.4%,中位OS、RFS期未達;Eos~+inv(16)~-組總體CR率達91.7%,1箇療程CR率達69.2%,中位OS期為14.3箇月,中位RFS期為12.4箇月.統汁學分析錶明,Eos~+inv(16)~+組、Eos~+inv(16)~-組OS、RFS期差異均有統計學意義.結論單獨伴有Eos比例升高可作為AML-M_4患者預後良好因素之一,其中Eos~+inv(16)~+組預後最好.Eos~+組患者具有髮病年齡較小、血小闆計數低的特點.
목적 탐토영향급성수계백혈병(AML)-M_4형환자생존、예후적주요인소.방법 70례AML-M_4환자분위이조:①반기산립세포비례증고단불반유inv(16)[Eos~+inv(16)~-]조;②기산립세포비례증고반유inv(16)[Eos~+inv(16)~+]조;③불반유기산립세포비례증고(Eos~-)조.총결분석환자림상표현、면역분형、염색체핵형급생존정황,분석영향총체생존(OS)시간、왕복발생존(RFS)시간적인소.결과 70례AML-M_4환자완전완해(CR)솔85.7%,기중1개료정CR솔71.4%;소유환자적중위OS기위20.0(1.2～162.4)개월,체CR환자적중위RFS기위78.0(1.2～129.5)개월;3년、5년OS솔분별위42%、42%,3년、5년RFS솔분별위59%、54%.Eos조총체CR솔76.9%,1개료정CR솔61.5%,중위OS기위11.2개월,중위RFS기위10.8개월;Eos~+조총체CR솔96.8%,1개료정CR솔89.6%,중위OS、RFS기미체.통즙학분석표명,량조재총체CR솔、OS화RFS기차이균유통계학의의.Eos~+조내분석표명,Eos~+inv(16)~+조총체CR솔체100%,1개료정CR솔체94.4%,중위OS、RFS기미체;Eos~+inv(16)~-조총체CR솔체91.7%,1개료정CR솔체69.2%,중위OS기위14.3개월,중위RFS기위12.4개월.통즙학분석표명,Eos~+inv(16)~+조、Eos~+inv(16)~-조OS、RFS기차이균유통계학의의.결론단독반유Eos비례승고가작위AML-M_4환자예후량호인소지일,기중Eos~+inv(16)~+조예후최호.Eos~+조환자구유발병년령교소、혈소판계수저적특점.
Objective To investigate factors that affect survival and prognosis of acute myeloid leukemia(AML)-M_4.Methods Seventy AML-M_4 patients were divided into three groups,neither eosinophilia nor inv(16)[Eos~-],eosinophilia with inv(16)[Eos~+inv(16)~+],and eosinophilia with no inv(16)[Eos~+inv(16)~-]. Clinical features,immunophenotype,chromosome karyotype,overall survival(OS) and relapse-free survival(RFS)were analyzed.Results The total complete remssion(CR)rate was 86.9%,CR rate after the first course of induction therapy was 72.4%.The median OS was 20(1.2-162.4)months,and median RFS 78.0(1.2-129.5)months.The 3 and 5 year OS rates were 42%and 42%,and 3 and 5 year RFS rates were 59%and 54%,respectively.The CR rate.CR after the first course of induction therapy and the median OS for the Eos~-group were 78.9%,61.5%and 11.2(1.2-162.4)months;for the Eos~+group were 96.8%,89.6%and did not reach;for the Eos~+invl6~+ group were 100%,94.4%and did not reach;and for the Eos~+inv(16)~- group were 91.7%.69.2% and 14.3 months respectively.The statistical assay showed significant difference between Eos~+inv(16)~- and Eos~+inv(16)~+ groups in OS.The Eos~+ patients present with early onset and low count of platelets.Conclusion Eosinophilia emerged as a favorable prognostic factor,and the concomitant presence of both eosinophilia and inv(16) is associated with a significantly favorlable prognosis.
