原发性急性髓系白血病预后相关因素分析  

Analysis of prognostic factors of de novo acute myeloid leukemia

作　　者：武玉慧[1] 涂三芳[1] 郭坤元[1] 李玉华[1] 

机构地区：[1]南方医科大学珠江医院血液科,广州市510282

出　　处：《实用医学杂志》2012年第8期1304-1307,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金(编号:30500607);教育部新世纪优秀人才支持计划(编号:NCET-09-0087);广东省自然科学基金重点项目(编号:9251051501000007)

摘　　要：目的:探讨原发性急性髓系白血病(AML)患者预后的影响因素,为改善患者预后,延长生存期提供临床依据。方法:回顾性分析2006年6月至2010年12月在我院就诊的原发性急性髓系白血病(除外AML-M3)109例,采用Kaplan-Meier生存分析法分析患者性别、年龄、初诊时外周血白细胞计数、血红蛋白浓度、血小板计数、骨髓涂片原始细胞百分数、细胞遗传学、首次诱导是否缓解与总生存时间(OS)及无复发生存期(RFS)的关系,log-rank检验对其可能的预后影响因素进行单因素分析,多元比例危险率COX回归模型进行多因素分析。结果:患者完全缓解(CR)率为56.88%,中位OS为9.5个月,中位RFS为5.5个月。年龄大于60岁、细胞遗传学高危组和首次诱导化疗未获得CR的患者OS及RFS较短(P<0.05),为预后不利因素,且对预后具有独立影响。结论:根据急性髓系白血病预后相关因素可对其进行预后判断,从而为个体化分层治疗提供临床依据,对延长患者总生存时间及无病生存期具有重要意义。Objective To analyze the prognostic factors of de novo acute myeloid leukemia （AML）, and provide clinical evidence for improving patient, s prognosis and prolonging their survival. Methods 109 patients with de novo AML （except AML-M3）, who were admitted to Zhujiang Hospital from June 2006 to December 2010, were enrolled in this study. The Kaplan-Meier method was used to estimate overall survival （OS） and relapse-free survival （RFS）. A single-factor analysis of prognostic factors of AML was done by using the log-rank test. Prognostic factors for survival were analyzed in a multiple, multivariate Cox regression model for OS. All statistical analysis were performed in SPSS Version 13.0. Results The complete remission （CR） ratio was 56.88%. The median OS and RFS were 9.5 and 5.5 months, respectively. The factors such as age 〉 60 years, high-risk cytogenetic subgroup and failing to achieve CR after first induction chemotherapy had poor influence on OS and RFS （P 〈 0.05）. Conclusions The prognosis of patients with AML can be assessed according to these prognostic factors. The individual therapy concerning the risk factors should be applied for improving survival.

关 键 词：白血病 髓样 急性 粒细胞 原发 预后因素 

分 类 号：R733.71[医药卫生—肿瘤]