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作 者:周强[1] 马洪兵[1] 刘作凤 崔旭[1] 陈心传[1] 李建军[1] 郑沁[2] 余江[2] 刘霆[1] 贾永前[1]
机构地区:[1]四川大学华西医院血液内科血液实验室,成都610041 [2]四川大学华西医院实验医学科
出 处:《临床血液学杂志》2015年第6期949-953,共5页Journal of Clinical Hematology
摘 要:目的:分析Evi1基因阳性急性髓细胞白血病(AML)患者的临床特征以及预后特点。方法:收集14例Evi1基因阳性AML患者的临床以及实验室资料,其中男、女各7例,中位年龄49(31~67)岁,初诊时白细胞计数(27.50±41.61)×109/L,血红蛋白(75.50±20.92)g/L,血小板计数(42.86±46.73)×109/L,骨髓原始细胞百分比(49.60±23.30)%。3例由骨髓增生异常综合征(MDS)转化而来,伴有病态造血的比例为42.86%(6/14),表现为髓系形态异常。存在染色体异常的比例为22.22%(2/9),其中伴有3号染色体异常1例,7号染色体缺失1例。结果:14例患者中12例进行诱导化疗,5例(41.67%)获得完全缓解,患者中位生存时间为122.5(10~562)d,12个月总体生存率为47.9%,18个月总体生存率为16.0%。结论:Evi1基因阳性AML常常伴有不同程度的病态造血,且与MDS转化有关,其治疗后的完全缓解率低,总体生存期短,预后差。Objective:To analyze the clinical characters and prognostic features of acute myeloid leukemia patients with Evi1 gene positive.Method:We included 14 adult AML patients(7 males and 7 females,aged 31 to 67years,median 49years)with Evi1 gene positive.At diagnosis,WBC was(27.50±41.61)×109/L,HGB was(75.50±20.92)g/L,PLT was(42.86±46.73)×109/L,bone marrow blast was(49.60±23.30)%.Three patients were transformed from MDS,and proportion with dysplasia was 42.86%(6/14),which mainly manifested myeloid morphologic abnormalities.The proportion of parents with chromosomal abnormalities was 22.22%(2/9),one with chromosome 3 abnormality and the other with missing chromosome 7.Result:Twelve of 14 patients received induction chemotherapy,and the complete remission rate was 41.67%(5/12).The median survival time was 122.5(10to 562)days.One-year overall survival rate was 47.9% and 18 months overall survival rate was 16.0%.Conclusion:Evi1gene positive AML patients have high proportion dysplasia and relate to MDS transformation,besides the patients have low complete remission,short overall survival and poor prognosis.
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