中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2014年
12期
1058-1064
,共7页
林冬%周春林%魏辉%刘兵城%王迎%刘凯奇%李巍%宫本法%王津雨
林鼕%週春林%魏輝%劉兵城%王迎%劉凱奇%李巍%宮本法%王津雨
림동%주춘림%위휘%류병성%왕영%류개기%리외%궁본법%왕진우
白血病,髓样,急性%WHO分型%治疗结果
白血病,髓樣,急性%WHO分型%治療結果
백혈병,수양,급성%WHO분형%치료결과
Leukemia,myeloid,acute%WHO classification%Treatment outcome
目的 了解单中心成人急性髓系白血病(AML)的临床特点、近期和远期疗效.方法 1999至2010年在中国科学科学院血液病医院白血病诊断治疗中心诊断、治疗的822例AML患者,按FAB和WHO分型标准分别诊断分型,分析患者的临床和预后特点.结果 822例AML患者的中位发病年龄为38.5(15~ 83)岁,分型以急性原始和幼稚单核细胞白血病(M5)、AML伴t(15;17)/PML-RARα(APL)和AML伴t(8;21)/AML1-ETO (M2b)为主,分别占总病例数的29.7%、20.9%和14.6%.AML伴t(15;17)/PML-RARα的完全缓解(CR)率为95.2%,诱导死亡率为4.8%,预计5年总生存(OS)率和无病生存(DFS)率分别为87.5%和88.8%.AML其他类型(非APL,Non-APL)的CR率为82.0%,诱导死亡率为4.2%,预计5年OS率和DFS率均为48.8%.按细胞遗传学预后分层,预后良好、中等和不良的Non-APL预计3年OS率分别为69.5%、52.8%和29.8%,差异有统计学意义(P< 0.01).影响Non-APLOS的因素为发病年龄、染色体核型、接受大/中剂量阿糖胞苷的疗程数和是否进行造血干细胞移植.结论 本组AML患者较年轻,疾病亚型分布与国外不尽一致.APL和Non-APL的近期和远期疗效与国外相当.按WHO标准诊断分型、依预后分层实施治疗是提高AML整体疗效的关键.
目的 瞭解單中心成人急性髓繫白血病(AML)的臨床特點、近期和遠期療效.方法 1999至2010年在中國科學科學院血液病醫院白血病診斷治療中心診斷、治療的822例AML患者,按FAB和WHO分型標準分彆診斷分型,分析患者的臨床和預後特點.結果 822例AML患者的中位髮病年齡為38.5(15~ 83)歲,分型以急性原始和幼稚單覈細胞白血病(M5)、AML伴t(15;17)/PML-RARα(APL)和AML伴t(8;21)/AML1-ETO (M2b)為主,分彆佔總病例數的29.7%、20.9%和14.6%.AML伴t(15;17)/PML-RARα的完全緩解(CR)率為95.2%,誘導死亡率為4.8%,預計5年總生存(OS)率和無病生存(DFS)率分彆為87.5%和88.8%.AML其他類型(非APL,Non-APL)的CR率為82.0%,誘導死亡率為4.2%,預計5年OS率和DFS率均為48.8%.按細胞遺傳學預後分層,預後良好、中等和不良的Non-APL預計3年OS率分彆為69.5%、52.8%和29.8%,差異有統計學意義(P< 0.01).影響Non-APLOS的因素為髮病年齡、染色體覈型、接受大/中劑量阿糖胞苷的療程數和是否進行造血榦細胞移植.結論 本組AML患者較年輕,疾病亞型分佈與國外不儘一緻.APL和Non-APL的近期和遠期療效與國外相噹.按WHO標準診斷分型、依預後分層實施治療是提高AML整體療效的關鍵.
목적 료해단중심성인급성수계백혈병(AML)적림상특점、근기화원기료효.방법 1999지2010년재중국과학과학원혈액병의원백혈병진단치료중심진단、치료적822례AML환자,안FAB화WHO분형표준분별진단분형,분석환자적림상화예후특점.결과 822례AML환자적중위발병년령위38.5(15~ 83)세,분형이급성원시화유치단핵세포백혈병(M5)、AML반t(15;17)/PML-RARα(APL)화AML반t(8;21)/AML1-ETO (M2b)위주,분별점총병례수적29.7%、20.9%화14.6%.AML반t(15;17)/PML-RARα적완전완해(CR)솔위95.2%,유도사망솔위4.8%,예계5년총생존(OS)솔화무병생존(DFS)솔분별위87.5%화88.8%.AML기타류형(비APL,Non-APL)적CR솔위82.0%,유도사망솔위4.2%,예계5년OS솔화DFS솔균위48.8%.안세포유전학예후분층,예후량호、중등화불량적Non-APL예계3년OS솔분별위69.5%、52.8%화29.8%,차이유통계학의의(P< 0.01).영향Non-APLOS적인소위발병년령、염색체핵형、접수대/중제량아당포감적료정수화시부진행조혈간세포이식.결론 본조AML환자교년경,질병아형분포여국외불진일치.APL화Non-APL적근기화원기료효여국외상당.안WHO표준진단분형、의예후분층실시치료시제고AML정체료효적관건.
Objective To investigate the characteristics and the short-or long-term treatment outcomes of the adult patients with acute myeloid leukemia (AML) in China.Methods From 1999 to 2010,822 adult cases with AML were enrolled,diagnosed and classified by the FAB and WHO criteria,respectively.The treatment outcomes and prognostic factors were analyzed retrospectively.Results In all patients with a median age of 38.5 (15-83) years,acute monoblastic and monocytic leukemia (M5),AML with t (15;17)/PML-RARα (APL) and AML with t (8;21)/AML1-ETO (M2b) were the most common subtypes,accounting for 29.7%,20.9% and 14.6% respectively.In APL patients,CR was achieved in 95.2%,with an early death (ED) rate of 4.8%.And the estimated overall survival (OS) and disease-free survival (DFS) at 5 year was 87.5% and 88.8%,respectively.Patients with other AML subtype (NonAPL) revealed a CR rate of 82.0%,ED of 4.3%,and estimated 5-year OS and DFS both of 48.8%.The OS rate of Non-APL patients at 3-year varied significantly (P<0.01) among three prognostic groups by cytogenetic risk stratification:favorable,69.5%; intermediate,52.8%; unfavorable,29.8%.The prognostic factors for OS among Non-APL included age,cytogenetic abnormalities,courses of the median/high-dose cytarabine and allogeneic hematopoietic stem cell transplantation.Conclusion When compared with the previous reports,the AML patients in our study were younger and showed a different subtype distribution.Treatment outcomes of APL and Non-APL were just the same as those in international leukemia centers.Chemotherapy by risk stratification,after diagnosis and classification according to the WHO criteria,is a key point to improve the outcomes in AML.