白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2010年
11期
672-674
,共3页
白血病,粒细胞,急性%老年人%维甲酸
白血病,粒細胞,急性%老年人%維甲痠
백혈병,립세포,급성%노년인%유갑산
Leukemia,myelocytic,acute%Aged%Tretinoin
目的 探讨老年人初治急性早幼粒细胞白血病(APL)的临床特点、治疗及预后.方法 回顾性比较分析21例老年及89例中青年(＜60岁)初治APL患者的临床资料,并按白细胞(WBC)计数的不同进行老年人APL分组比较.结果 老年APL与中青年APL患者的性别(男女性别比11∶10对47∶42)、治疗前的WBC(高白细胞比例:23.8%比16.9%)、骨髓原始细胞+早幼粒细胞(0.83±0.11对0.83±0.12)、诱导治疗的完全缓解(CR)率(71.4%对84.3%)、达CR的天数[(35.7±10.1)d对(39.1±13.5)d]、维甲酸综合征(RAS)发生率(14.3%对22.5%)、弥散性血管内凝血(DIC)发生率(52.4%对34.8%)及2年总生存率(72.7%对80.0%)差异均无统计学意义(P＞0.05),老年APL患者诱导治疗过程中早期死亡率明显高于中青年APL患者(28.6%对11.2%)(P＜0.05).21例接受诱导治疗的老年患者中,5例为高白细胞型,16例为非高白细胞型,高白细胞组老年APL患者的DIC和早期死亡发生率分别为80%、60%,高于非高白细胞组(43.8%、18.8%),而CR率较低(40.0%对81.3%).结论 老年及中青年APL患者均具有较好的预后,高白细胞型诱导治疗疗效低于非高白细胞型.
目的 探討老年人初治急性早幼粒細胞白血病(APL)的臨床特點、治療及預後.方法 迴顧性比較分析21例老年及89例中青年(＜60歲)初治APL患者的臨床資料,併按白細胞(WBC)計數的不同進行老年人APL分組比較.結果 老年APL與中青年APL患者的性彆(男女性彆比11∶10對47∶42)、治療前的WBC(高白細胞比例:23.8%比16.9%)、骨髓原始細胞+早幼粒細胞(0.83±0.11對0.83±0.12)、誘導治療的完全緩解(CR)率(71.4%對84.3%)、達CR的天數[(35.7±10.1)d對(39.1±13.5)d]、維甲痠綜閤徵(RAS)髮生率(14.3%對22.5%)、瀰散性血管內凝血(DIC)髮生率(52.4%對34.8%)及2年總生存率(72.7%對80.0%)差異均無統計學意義(P＞0.05),老年APL患者誘導治療過程中早期死亡率明顯高于中青年APL患者(28.6%對11.2%)(P＜0.05).21例接受誘導治療的老年患者中,5例為高白細胞型,16例為非高白細胞型,高白細胞組老年APL患者的DIC和早期死亡髮生率分彆為80%、60%,高于非高白細胞組(43.8%、18.8%),而CR率較低(40.0%對81.3%).結論 老年及中青年APL患者均具有較好的預後,高白細胞型誘導治療療效低于非高白細胞型.
목적 탐토노년인초치급성조유립세포백혈병(APL)적림상특점、치료급예후.방법 회고성비교분석21례노년급89례중청년(＜60세)초치APL환자적림상자료,병안백세포(WBC)계수적불동진행노년인APL분조비교.결과 노년APL여중청년APL환자적성별(남녀성별비11∶10대47∶42)、치료전적WBC(고백세포비례:23.8%비16.9%)、골수원시세포+조유립세포(0.83±0.11대0.83±0.12)、유도치료적완전완해(CR)솔(71.4%대84.3%)、체CR적천수[(35.7±10.1)d대(39.1±13.5)d]、유갑산종합정(RAS)발생솔(14.3%대22.5%)、미산성혈관내응혈(DIC)발생솔(52.4%대34.8%)급2년총생존솔(72.7%대80.0%)차이균무통계학의의(P＞0.05),노년APL환자유도치료과정중조기사망솔명현고우중청년APL환자(28.6%대11.2%)(P＜0.05).21례접수유도치료적노년환자중,5례위고백세포형,16례위비고백세포형,고백세포조노년APL환자적DIC화조기사망발생솔분별위80%、60%,고우비고백세포조(43.8%、18.8%),이CR솔교저(40.0%대81.3%).결론 노년급중청년APL환자균구유교호적예후,고백세포형유도치료료효저우비고백세포형.
Objective To investigate the clinical features, therapy and prognosis of elderly patients with newly diagnosed acute promyelocytic leukemia (APL). Methods The clinical features of 21 elderly patients and 89 patients aged ＜60 with newly diagnosed APL were retrospectively analyzed. Additionally,elderly patients were divided into different groups according to the count of white blood cell (WBC). Results There were no significant differences between elderly patients and patients aged ＜60 in the aspect of sex (male/female: 11/10 vs 47/42), WBC count (high initial WBC: 23.8 % vs 16.9 %), the percentage of bone marrow blasts plus promyelocytes (0.83±0.11 vs 0.83±0.12), complete remission (CR) rate (71.4 % vs 84.3 %),the time of CR occurrence (35.7±10.1 vs 39.1±13.5), the occurrence of retinoic acid syndrome(RAS) (14.3 % vs 22.5 %), disseminated intravascular coagulation (DIC) (52.4 % vs 34.8 %) as well as 2 years overall survival rate (72.7 % vs 80.0 %) (P ＞0.05). Of the 21 elderly patients who received inductive treatment, 5 with high initial WBC and 16 without high initial WBC. The incidences of DIC, early death in high initial WBC group were 80 %, 60 % respectively, which were higher than the group without high initial WBC (43.8 %,18.8 % respectively), whereas CR rate for the group with high initial WBC (40.0 %) was lower than that for the group without high initial WBC (81.3 %). Conclusion Elderly patients with APL could have fine prognosis as well as patients aged ＜60. The results of inductive treatment of elderly patients in high initial WBC group were poor as compared with the group without high initial WBC.
