高白细胞急性白血病的临床特点分析  

Analysis of Clinical Characteristics of Hyperleukemic Acute Leukemia

作　　者：凌慧君 陈赵玲[2] 熊健 阮涛 郝春宁 刘岐焕[2] Ling Huijun;Chen-Zhao Ling;Xiong Jian;Ruan Tao;Hao Chunning;Liu Qihuan(The Postgraduate Training Base of Jinzhou Medical University,Sinopharm Dongfeng General Hospital,Hubei University of Medicine;Department of Hematology and Rheumatisim,Guoyao Dongfeng General Hospital Affiliated to Hubei University of Medicine,Shiyan 442000 China)

机构地区：[1]锦州医科大学湖北省十堰国药东风总医院研究生培养基地 [2]湖北医药学院附属国药东风总医院血液风湿内科,湖北十堰442000

出　　处：《锦州医科大学学报》2022年第3期87-91,共5页Journal of Jinzhou Medical University

摘　　要：目的高白细胞急性白血病是一类早期并发症及病死率较高的急性白血病。本文主要对2017年2月至2021年5月我院52例高白细胞性急性白血病患者进行回顾性分析,为该类患者早期干预及预后提供临床依据。方法收集国药东风总医院52例初诊为高白细胞急性白血病患者的基本信息及临床数据,采用SPSS 23.0进行病例前后自身配对样本t检验;Kaplan-Meier生存分析、COX回归分析及相关性分析,P<0.05具有统计学意义结论。结果1周内病死率为1.9%,1月内病死率为5.7%,心力衰竭(P=0.028)、呼吸衰竭(P=0.033)、肺部感染(P=0.024)是引起患者死亡的独立影响因素。白细胞单采和白细胞单采+羟基脲均能显著降低白细胞水平,单采+羟基脲对于红细胞(P=0.017)、血红蛋白(P<0.001)影响显著,且并未增加患者出血风险(P=0.174)。结论对于高白细胞性急性白血病早期积极降低肿瘤负荷,积极预防感染,尽可能的为进一步治疗争取时间,延长生存时间。Objective Hyperleukemic acute leukemia(HAML)is a kind of acute leukemia with early complication and high mortality.In this study,52 patients with hyperleukemic acute leukemia in our hospital from February 2017 to May 2021 were retrospectively analyzed to provide clinical basis for early intervention and prognosis of such patients.Methods Basic information and clinical data of 52 newly diagnosed patients with hyperleukemic acute leukemia were collected from Sinopharm Dongfeng General Hospital.SPSS 23.0 was used for t test of self-paired samples before and after the case.Kaplan-Meier survival analysis,COX regression analysis and correlation analysis showed that there was statistically significant(P<0.05).Results The fatality rate within 1 week was 1.9%and within 1 month was 5.7%.Heart failure(P=0.028),respiratory failure(P=0.033)and pulmonary infection(P=0.024)were the independent factors causing death of patients.Leukocyte monotherapy and leukocyte monotherapy in combination with hydroxyurea significantly reduced leukocyte level.Monotherapy in combination with hydroxyurea significantly affected RBC(P=0.017)and hemoglobin(P<0.001),but did not increase the risk of bleeding(P=0.174).Conclusion In the early stage of hyperleukemic acute leukemia,it is necessary to reduce tumor load and prevent infection,so as to gain time for further treatment and prolong survival time.

关 键 词：高白细胞急性白血病 白细胞单采 临床特征 危险因素 回顾性分析 

分 类 号：R733.71[医药卫生—肿瘤]