急性髓系白血病患者巩固化疗过程中未成熟网织红细胞分数检测的临床意义  

Clinical significance of immature reticniocyte fraction in patients with acute myeloid leukemia following consolidation chemotherapy with high-dose cytarabine

作　　者：陈琼[1] 程毅敏[2] 朱琦[2] 

机构地区：[1]上海交通大学医学院附属第九人民医院检验科,200011 [2]上海交通大学医学院附属第九人民医院血液科,200011

出　　处：《白血病．淋巴瘤》2013年第5期291-293,共3页Journal of Leukemia & Lymphoma

摘　　要：目的探讨急性髓系白血病（AML）患者在接受大剂量阿糖胞苷巩固化疗后骨髓抑制和恢复过程中包括未成熟网织红细胞分数（IRF）在内的外周血各参数的变化及其临床意义。方法采用全自动血细胞分析仪动态检测30例AML患者接受大剂量阿糖胞苷巩固化疗前后外周血中性粒细胞绝对计数（ANC）、血小板计数（Ph）和IRF，并对各个参数的变化进行分析比较。结果患者巩固化疗后，ANC、Pit和IRF平均恢复时间分别为（9．2±2．5）d、（11．3±3．7）d和（5．0±2．6）d，IRF恢复时间短于ANC和Pl￡回升时间（P〈0．05），而ANC恢复时间短于Plt回升时间（P〈0．05）。不同FAB分型患者间及基于细胞遗传学和分子生物学危险因素分层患者间ANC、Pit和IRF平均恢复时间差异均无统计学意义（P〉0．05）。结论IRF是AML患者接受大剂量阿糖胞苷巩固化疗后提示骨髓造血功能恢复的早期指标，对于评估疗效具有重要临床意义：Objective To investigate the clinical significance of peripheral blood parameters including immature retieulocyte fraction （IRF） in monitoring the hematopoietic recovery of patients with acute myeloid leukemia after receiving consolidation chemotherapy with high dose eytarabine （HDAC）. Methods The peripheral blood parameters, including absolute neutrophil （ANC） and platelet （Plt） counts as well as IRF, were measured by Sysmex XE-2100 automated hematology analyzer before and after consolidation chemotherapy with HDAC in 30 patients with acute myeloid leukemia. These peripheral blood parameters were further statistically analyzed and compared. Results Following consolidation chemotherapy, the median time to recovery for ANC, Plt and IRF was （9.2±2.5） days, （1 1.3±3.7） days and （5.0±2.6） days, respectively. In comparison with ANC and Pit recovery, IRF showed significantly early recovery （P 〈 0.05）. Additionally, ANC raised preceding Pit recovery （P 〈 0.05）. However, the median recovery time of ANC, Plt and IRF showed little difference among these patients further subgrouped according to FAB and risk based classification （P 〉 0.05）. Conclusion IRF is an early indicator for the hematopoietic recovery of patients with acute myeloid leukemia following consolidation chemotherapy with HDAC, which could provide important clinical information to evaluate therapeutic efficacy.

关 键 词：白血病 髓样 急性 药物疗法 阿糖胞苷 未成熟网织红细胞分数 

分 类 号：R733[医药卫生—肿瘤]