急性髓细胞白血病FAB分类与WHO分类的临床比较分析  

Comparative analysis:FAB and WHO classification of acute myeloid leukemia

作　　者：徐岚[1] 钟华[1] 黄洪晖[1] 钟璐[1] 沈莉菁[1] 胡霄飞[1] 肖菲[1] 韩洁英[1] 陈芳源[1] 

机构地区：[1]上海交通大学医学院附属仁济医院血液科,上海200127

出　　处：《肿瘤》2008年第4期346-349,共4页Tumor

摘　　要：目的:对急性髓系白血病(acute myeloid leukemia,AML)患者进行FAB(French-American-British Cooperative Group)和WHO(World Health Organization)两种分类诊断的比较研究。方法:118例AML患者根据FAB和WHO分类方法重新分类诊断,并进行中位生存时间(median survival time,MST)和总生存率(overall survival,OS)的预后评估。结果:根据WHO分类:AML伴有重现细胞遗传学异常35例(33.7%),AML伴有多系病变21例(20.2%),治疗相关性AML 2例(1.9%),AMLWHO分类不明或同FAB分类46例(44.2%)。各组的3年OS分别为(75.1±7.8)%、(47.4±13.9)%、(50.0±35.4)%和(54.9±10.0)%,差异有统计学意义(P<0.001)。不同类型的染色体对AML预后影响明显。染色体预后良好的3年OS为(87.4±6.9)%,预后中等的3年OS为(69.3±7.3)%,预后不良的3年OS为(19.6±10.9)%,差异有统计学意义(P<0.001)。结论:对于初发的AML患者进行WHO分类,能更有效地评估疾病的发展和预后。Objective： To make a comparative study on the differential diagnosis of the acute myeloid leukemia based on French- American-British Cooperative Group （FAB） and World Health Organization （WHO） standard. Methods： The 118 patients were recruited who were diagnosed with de novo AML. All cases were re-classified according to FAB and WHO classification standard. The median survival time and overall survival rate were recorded for prognosis evaluation. Results：Based on WHO classication standard, there were 35 AML patients （33.7%） with recurrent cytogenetic abnormalities, 21 patients （20.2%） with muhilineage dysplasia, and 2 patients （ 1.9% ） with therapy-related AML,and 46 patients （44.2%） AML not otherwise categorized. The 3-year survival rate were （75.1 ± 7.8）% , （47.4±13.9） %, （50.0±35.4）%, and （54.9 ±10.0）% in different groups based on WHO standard. The difference was significant （ P 〈0.001 ）. Different karyotypes of chromosome had significant effects on the prognosis of AML. The median OS rate was （ 87.4 ± 6.9） % for patients with good prognosis, （69.3 ±7.3） % for patients with moderate prognosis, and （ 19.6 ± 10.9） % for patients with poor prognosis. The difference was significant （P 〈 0. 001 ）. Conclusion：Our study results suggest that classification of primary AML patients according to the WHO standard was more effective for evaluating progression and prognosis of AML.

关 键 词：白血病 髓样 急性 诊断 鉴别 预后 

分 类 号：R733.71[医药卫生—肿瘤] R730.4[医药卫生—临床医学]