国际输血及血液学杂志
國際輸血及血液學雜誌
국제수혈급혈액학잡지
INTERNATIONAL JOURNAL OF BLOOD TRANSFUSION AND HEMATOLOGY
2013年
1期
7-10
,共4页
粒细胞肉瘤%急性髓系白血病%异基因造血干细胞移植
粒細胞肉瘤%急性髓繫白血病%異基因造血榦細胞移植
립세포육류%급성수계백혈병%이기인조혈간세포이식
granulocytic sarcoma%acute myeloid leukemia%allogeneic hematopoietic stem cell transplant
目的 探讨粒细胞肉瘤(GS)的临床特点、治疗方法及预后.方法 选择2005年10月1日至2012年7月31日于苏州大学附属第一医院确诊的25例GS患者为研究对象.根据患者是否进行化疗联合异基因造血干细胞移植(allo-HSCT)治疗,分为移植组(n=6)和未移植组(n=19).回顾性分析患者的临床特点、病理特征以及治疗方法,并随访至2012年7月31日,应用Kaplan-Meier生存分析法和Log-Rank检验,比较两组患者的治疗效果及预后情况(本研究遵循的程序符合本院人体实验委员会所制定的伦理学标准,得到该伦理会批准).结果 GS好发部位为乳腺、皮肤、淋巴结等.25例GS患者中,移植组与未移植组3年总生存(OS)率分别为66.7％±27.2％和15.9％±9.5％,2组OS率比较差异有统计学意义(x2 =7.188,P＜0.05),移植组3年OS率明显高于未移植组.结论 GS临床少见,预后不良,诊断主要依靠免疫病理学试验,临床上以高剂量阿糖胞苷为主的化疗是较为有效的治疗方案,allo-HSCT有望成为一种更为积极的治疗方案,但治疗的总体效果及远期预后仍有待进一步临床观察.
目的 探討粒細胞肉瘤(GS)的臨床特點、治療方法及預後.方法 選擇2005年10月1日至2012年7月31日于囌州大學附屬第一醫院確診的25例GS患者為研究對象.根據患者是否進行化療聯閤異基因造血榦細胞移植(allo-HSCT)治療,分為移植組(n=6)和未移植組(n=19).迴顧性分析患者的臨床特點、病理特徵以及治療方法,併隨訪至2012年7月31日,應用Kaplan-Meier生存分析法和Log-Rank檢驗,比較兩組患者的治療效果及預後情況(本研究遵循的程序符閤本院人體實驗委員會所製定的倫理學標準,得到該倫理會批準).結果 GS好髮部位為乳腺、皮膚、淋巴結等.25例GS患者中,移植組與未移植組3年總生存(OS)率分彆為66.7％±27.2％和15.9％±9.5％,2組OS率比較差異有統計學意義(x2 =7.188,P＜0.05),移植組3年OS率明顯高于未移植組.結論 GS臨床少見,預後不良,診斷主要依靠免疫病理學試驗,臨床上以高劑量阿糖胞苷為主的化療是較為有效的治療方案,allo-HSCT有望成為一種更為積極的治療方案,但治療的總體效果及遠期預後仍有待進一步臨床觀察.
목적 탐토립세포육류(GS)적림상특점、치료방법급예후.방법 선택2005년10월1일지2012년7월31일우소주대학부속제일의원학진적25례GS환자위연구대상.근거환자시부진행화료연합이기인조혈간세포이식(allo-HSCT)치료,분위이식조(n=6)화미이식조(n=19).회고성분석환자적림상특점、병리특정이급치료방법,병수방지2012년7월31일,응용Kaplan-Meier생존분석법화Log-Rank검험,비교량조환자적치료효과급예후정황(본연구준순적정서부합본원인체실험위원회소제정적윤리학표준,득도해윤리회비준).결과 GS호발부위위유선、피부、림파결등.25례GS환자중,이식조여미이식조3년총생존(OS)솔분별위66.7％±27.2％화15.9％±9.5％,2조OS솔비교차이유통계학의의(x2 =7.188,P＜0.05),이식조3년OS솔명현고우미이식조.결론 GS림상소견,예후불량,진단주요의고면역병이학시험,림상상이고제량아당포감위주적화료시교위유효적치료방안,allo-HSCT유망성위일충경위적겁적치료방안,단치료적총체효과급원기예후잉유대진일보림상관찰.
Objective To explore the clinical features,treatments and prognosis of granulocytic sarcoma (GS).Methods Form 1st October 2005 to 31st July 2012,25 patients who were diagnosed as GS in the First Affiliated Hospital of Soochow University were included in this study.All of them were divided into transplantation group (n=6) and non transplantation group (n=19),according to whether accepted the treatment of chemotherapy combined with allogeneic hematopoietic stem cell transplantation (alloHSCT).A retrospective analysis was made of 25 cases GS patients including the clinical characteristics,pathologic presentation,treatment and outcome.The statistic difference was tested by using Kaplan-Meier survival analysis and line of Log Rank test.Results The predilection sites included breast,skin,lymph nodes,etc.The 3 years overall survival (OS) rate of transplantation group and non-transplantation group were 66.7％±27.2％ and 15.9％±9.5％,respectively.There was a significant difference of three-year OS rate between ransplantation group and non-transplantation group (x2=7.188,P＜0.05).Conclusions GS is a rarely diagnosed entity,and the prognosis is generally poor.The diagnosis of GS depends on immunopathology.The therapy with high dose of cytarabine containing is a proper treatment for GS.AlloHSCT may be a positive treatment of GS,but the benefit of the treatment and the long-term prognosis still needs to be further clinical observation.
