急性早幼粒细胞白血病患者外周血白细胞计数与早期死亡率关系  

Relationship between Peripheral Blood White Blood Cell Count and Early Death Rate in Patients with Acute Promyelocytic Leukemia

作　　者：王怀宇[1] 张欣欣[1] 张慧云[1] 王静[2] 陈丽梅[1] 王梦昌[1] 习杰英[1] 谢铭[1] 樊婷[1] 

机构地区：[1]西安交通大学第一附属医院血液科,陕西西安710061 [2]西安交通大学第一附属医院风湿科,陕西西安710061

出　　处：《中国实验血液学杂志》2017年第3期718-722,共5页Journal of Experimental Hematology

基　　金：国家自然科学基金(81541026);陕西省自然科学基础研究计划基金(2016JM8113);西安交通大学第一附属医院临床研究课题(XJTU1AHCR2014-012)

摘　　要：目的:探讨外周血白细胞计数与急性早幼粒细胞白血病(APL)患者早期死亡率的关系。方法:通过回顾性研究,分析近8年来116例初诊急性早幼粒细胞白血病患者诱导治疗前外周血白细胞计数最高值、诱导治疗后外周血白细胞计数最高值及整个病程中外周血白细胞计数最高值与早期死亡率的相关性。结果:在外周血白细胞计数>10×10~9/L的高危患者中,无论治疗前、治疗后及整个病程中,早期死亡患者的外周血白细胞计数最高值均明显高于生存患者(P<0.05);ROC曲线分析显示,治疗前急性早幼粒细胞白血病患者的外周血白细胞计数的极高危阈值为70×10~9/L(P<0.05),治疗后的极高危阈值为96.4×10~9/L,在整个病程中的极高危阈值为91.5×10~9/L(P<0.01),超过极高危阈值的患者死亡率明显升高(P<0.05)。结论:急性早幼粒细胞白血病患者整个病程中各时间点的外周血白细胞计数均与患者早期死亡率密切相关,有效控制外周血白细胞计数可能降低APL早期死亡率。Objective： To investigate the relationship between peripheral white blood cell count and early death rate of the patients with acute promyelocytic leukemia （APL）. Methods- Through retrospective study, the relationship of early death rate in 116 cases newly diagnosed APL patients with maximum of peripheral blood white blood cell count should be analyzed before and after induction therapy as well as in the whole course of disease during the past 8 years. Results： There was a close relationship between the peripheral white blood cell count and the early death rate in APL patients. Peripheral blood white blood cell count in the early died patients was significantly higher than that of the survival patients （ P 〈 0.05 ）. ROC analysis showed that the highest risk threshold of peripheral white cell count was 70 x 109/L （P 〈 0. 05 ） before treatment, while the highest risk threshold after treatment and in the whole course of disease were 96. 4 x 109/L（P 〈0.05） and 91.5 x 109/L（P 〈0.01 ） respectively. The dealth rate of patients with highest risk threshold was significantly increased （ P 〈 0.05 ）. Conclusion： The highest peripheral blood white blood cell count closely relates with the early death rate of patients at different time points in the whole course of disease. Control of peripheral white blood cell count may effectively reduce the early death rate of APL patients.

关 键 词：急性早幼粒细胞白血病 外周血白细胞计数 早期死亡率 

分 类 号：R733.71[医药卫生—肿瘤]