高白细胞性急性白血病50例临床研究  

Clinical Study on 50 Cases of Hyperleukocytic Acute Leukemia

作　　者：张宁 ZHANG Ning(Department of Internal Medicine,Dezhou Third People'sHospital,Dezhou Shandong 253500,China)

机构地区：[1]德州市第三人民医院内科,山东德州253500

出　　处：《中国卫生标准管理》2021年第16期84-87,共4页China Health Standard Management

摘　　要：目的分析高白细胞性急性白血病(hyperleukocytic acute leukemia,HAL)患者的临床分型、表现、疗效和预后情况。方法A组研究时间介于2015年11月—2017年11月间,共计HAL患者50例。B组选择同期入院诊治的非高白细胞性急性白血病(Nonhyperleukocytic acute leukemia,NHAL)患者50例,分析两组患者的临床特点。结果两组的急性髓细胞白血病(AML)分型中,A组的M3分型占比0,B组占比14.0%(χ^(2)=7.527,P=0.006);A组的M4分型占比16.0%,B组占比2.0%(χ^(2)=5.983,P=0.014);A组的M5分型占比24.0%,B组占比6.0%(χ^(2)=6.353,P=0.012),其他分型对比未见差异(P>0.05)。两组的相关临床表现相比较后存有明显差异(P<0.05)。A组的总有效率为56.0%,B组为88.0%(χ^(2)=12.698,P=0.000);A组的1年与3年后生存率均低于B组(P<0.05)。结论HAL患者的FAB分型多为AML,且以M5分型为主,患者伴有典型的临床表现,易于鉴别,且HAL的疗效不佳,远期预后不良,需要尽早对症治疗,尽量改善整体疗效。Objective To analyze the clinical classification,manifestation,curative effect and prognosis of patients with hyperleukocytic acute leukemia(HAL).Methods The study period of Group A was between November 2015 and November 2017,with a total of 50 HAL patients.Group B selected 50 non-hyperleukocytic acute leukemia(NHAL)patientswho were admitted to the hospital during the same period,and analyzed the clinical characteristics of the two groups.Results In the two groups of acute myeloid leukemia(abbreviated term AML),M3 accounted for 0%in group A and 14.0%in group B(χ^(2)=7.527,P=0.006);M4 accounted for 16.0%in group A and 2.0%in group B(χ^(2)=5.983,P=0.014);M5 accounted for 24.0%in group A and 6.0%in group B(χ^(2)=6.353,P=0.012);there was no difference in other types(P>0.05).There were significant differences in the clinical manifestations between the two groups(P<0.05).The total effective rate was 56.0%in group A and 88.0%in group B(χ^(2)=12.698,P=0.000).The 1-year and 3-year survival rates in group A were lower than those in group B(P<0.05).Conclusion The FAB classification of HAL patients is mostly AML,and M5 classification is the main type.Patients with typical clinical manifestations are easy to identify,and the curative effect of Hal is poor,and the long-term prognosis is poor.It is necessary to symptomatic treatment as soon as possible to improve the overall curative effect.

关 键 词：高白细胞性急性白血病 临床表现 分型 疗效 预后 生存率 鉴别诊断 

分 类 号：R733[医药卫生—肿瘤]