CAJ | 학술논문

　　目的分析老年急性白血病的分布及预后情况。方法选取2009年9月至2013年5月在我院未经治疗的、年龄大于60岁的急性白病患者340例，对其发病年龄、预后危险因素、治疗、生存时间等指标进行分析。结果340例60岁以上老年急性白血病患者中，中位发病年龄68岁，急性淋巴细胞白血病（ALL）24例（7.06%）；在急性髓细胞白血病（AML）314例中，初发AML（de novo AML）250例（79.62%）。急性早幼粒细胞白血病（APL）仅9例。初发AML （非APL）中细胞遗传学和分子生物学预后较好的34例（14.11%），预后差的61例（25.31%），随着年龄增加，预后较好的比例降低，而预后差的比例升高。在有生存资料的患者93例中，85例选择了化疗。年龄也对完全缓解（CR）率、总体生存有显著影响。化疗后获得CR的患者生存明显优于未获得CR的患者。结论老年急性白血病患者预后差，如何提高总体生存仍然是一个难题。
　　목적분석노년급성백혈병적분포급예후정황。방법선취2009년9월지2013년5월재아원미경치료적、년령대우60세적급성백병환자340례，대기발병년령、예후위험인소、치료、생존시간등지표진행분석。결과340례60세이상노년급성백혈병환자중，중위발병년령68세，급성림파세포백혈병（ALL）24례（7.06%）；재급성수세포백혈병（AML）314례중，초발AML（de novo AML）250례（79.62%）。급성조유립세포백혈병（APL）부9례。초발AML （비APL）중세포유전학화분자생물학예후교호적34례（14.11%），예후차적61례（25.31%），수착년령증가，예후교호적비례강저，이예후차적비례승고。재유생존자료적환자93례중，85례선택료화료。년령야대완전완해（CR）솔、총체생존유현저영향。화료후획득CR적환자생존명현우우미획득CR적환자。결론노년급성백혈병환자예후차，여하제고총체생존잉연시일개난제。
Objective To investigate the distribution and prognosis of elderly patients with acute leukemia. Methods Clinical data of 340 untreated acute leukemia patients with age over 60 years admitted in our hospital from September 2009 to May 2013 were enrolled in this study. Their onset age, prognostic risk factors, therapy and survival were retrospectively analyzed. Results In this cohort of patients, their median onset age was 68 years. There were 24 patients (7.06%) with acute lymphoblastic leukemia (ALL). In 314 patients with acute myeloblastic leukemia (AML), there were 250 patients (79.62%) with de novo AML, and 9 patients with acute promyelocytic leukemia (APL). There were 34 cases (14.11%) of de novo AML (non APL) having good prognosis based on cytogenetic and molecular biology, and 61 cases having unfavourable prognosis. The proportion of good prognosis was decreased along with the increase of age, while that of unfavourable prognosis was elevated. Among the 93 patients with survival data, 85 of them received chemotherapy. Age also exerted obvious effect on the complete remission (CR) rate and total survival rate. Patients who gained CR after chemotherapy had longer survival than those without CR. Conclusion The prognosis of elderly patients with acute leukemia is poor. How to improve the total survival rate is still a difficult task.