红细胞输注量为急性淋巴细胞白血病患儿3年无病生存时间的独立危险因素  

The amount of the red blood cells transfused is an independent risk factor for the three-year disease-free survival in the children with acute lymphoblastic leukemia

作　　者：肖昆[1] 乐爱平[1] 刘威[1] 杨丽云[1] 胡飘萍[1] XIAO Kun;LE Aiping;LIU Wei;HU Piaoping;YANG Liyun(The First Affiliated Hospital of Nanchang University, Nanchang 330006, China)

机构地区：[1]南昌大学第一附属医院输血科

出　　处：《中国输血杂志》2018年第2期165-168,共4页Chinese Journal of Blood Transfusion

基　　金：江西省科技重大项目(20144BBG70001)

摘　　要：目的探讨红细胞输注量对急性淋巴细胞白血病（ALL）患儿3年无病生存时间的影响。方法 2016年3月20日利用自行开发的临床用血管理与评价信息系统检索出2010年1月—2013年4月在本院血液科住院治疗的ALL患儿678例,从中共筛选纳入初治年龄0.05）;2）COX单因素回归分析：年龄、免疫学分型、临床危险度和红细胞输注量对ALL患儿3年无病生存时间均具有影响（P0.05）;3）COX多因素回归分析显示：临床危险度和红细胞输注量对ALL患儿3年无病生存时间有明显影响（P0.05）;4）生存曲线分析：不同临床危险度（低度、中度与高度危险）的ALL患儿3年无病生存率分别为1.0 vs 0.84 vs 0.42（P〈0.01）;不同红细胞输注量（≥0.21U/kg与〈0.21 U/kg）的ALL患儿3年无病生存率分别为0.58 vs 0.91（P〈0.05）。结论临床危险度与红细胞输注量均为ALL患儿3年无病生存时间的独立危险因素,ALL患儿治疗期间宜减少红细胞输注。Objective To investigate the influence of the amount of the red blood cells transfused on the three-year disease-free survival of the children with acute lymphoblastic leukemia（ ALL）. Methods A total of 678 child ALL cases were collected using a self-developed clinical blood informatic system,which covered cases from Jan,2010 to Apr,2013. 101 of the 678 cases involved children younger than 15 years old and were enrolled in our study. 6 indexes were used for COX regression analysis： Age,the initial diagnosis of peripheral blood WBC,immunology typing,clinical risk,the amount of the red blood cells transfused and clinical condition rating. This analysis was designed to reveal the impact of the red blood cell transfused on these children in a 3-year time frame. Results 1） Basic clinical data： Within 1—10 years,the children with a transfusion ratio of less than 0. 21 U/kg presented improved condition in primary peripheral blood WBC,T ALL and relapse compared to the ones transfused with a ratio of 0. 21 U/kg and higher.（ 5/50 vs 19/51,3/50 vs 16/51,5/50 vs 19/51 and4/50 vs 18/51） The difference was statistically significant（ P〈0. 05）. There was no statistical significance（ P〉0. 05） found in sex,Hb,clinical risk,transfusion of red blood cell infection,remission and mortality（ P〉0. 05）; 2） The COX regression single factors analysis showed that age, immunological classification,clinical risk and the amount of red blood cell transfused had impact on the 3-year disease-free survival time of children（ P〈0. 05） while no significant influence was found related to the initial diagnosis of peripheral WBC and disease relief（ P〉0. 05）; 3） The COX regression multiple factor analysis showed that the clinical risk degree and the amount of red blood cells transfused were statistically significant for the 3-years disease-free time in children with ALL（ P〈0. 05）,but age and immunological type were not（ P〉0. 05）; 4） The survival curve analysis showed that the 3-year disease-

关 键 词：红细胞输注量 儿童急性淋巴细胞白血病患儿 3年无病生存时间 COX回归分析 生存曲线 临床危险度 

分 类 号：R457.1[医药卫生—治疗学] R725.5[医药卫生—临床医学]