外周血细胞计数对老年急性髓系白血病生存预后影响.doc

外周血细胞计数对老年急性髓系白血病生存预后影响摘要: 目的:探讨不同外周血细胞计数对老年急性髓系白血病(AML)生存预后的影响。 方法:回顾分析我科1997~2008年收治的可评估的老年AML患者67例,按外周血细胞的不同 分组,进行完全缓解(CR)率的比较及单因素的Kaplan-Meier生存分析。结果:67例患者的 中 位生存期为4.2个月。20例(29.9%)获得完全缓解(CR),中位生存期为7.5个月;未缓解 的中位生存时间为3.5个月(P0.05)。白细胞计数≥50×1 09/ L组,中位生存时间为2.5个月,明显低于其他组别(P0.05)。结论:外周血高白细胞计数是老年AML患者预后不良 的因素,支持治疗对老年AMI很重要。 关键词:老年人;急性髓性白血病;预后;外周血细胞 中图分类号: R733.7 文献标识码: A 文章编号: 1008-2409(2009)05-0811-03 Prognostic analysis of peripheral blood cells in elderly patients with acute my eloid leukemia/LIN Wen-yuan, MO Dong-hua, CHEN Bei-li,et al.∥Department of Hematology, The Affiliated Hospital of Guilin Medical College, Gu ilin 541001, China Abstract: Objective: T o evaluate the prognosis of different peripheral blood cells in elderly patient s with acute myelogenous leukemia(AML). Methods: 67 elderly AML patients (M/F 42 /25, median age 72 years, range 60~81) diagnosedat our hospital from 1997 to 2008 were evaluated retrospectively. They were subg rouped by different periphera l blood cells. A comparison of the complete remission (CR) between them was test ed. The univariate Kaplan-Meier analysis was used to obtain survival curves. Results: The median survival of all patients was 4.2 months. 20 patients(29 .9%) ac hieved CR and the median survival was 7.5 months, as compared to 3.5 months ofpatients without CR (P0.05). The median survival w asonly 2.5 months for the patients with high leukocytecount (≥50×10?9/L),whic h was significantly shorter than that with low leukocyte count (P0.05). Conclusion: A high leukocyte count was the significant poor prognosticfactors for elderly AML patients, supportive care was important. Key words: elderly patient; acute myeloid leukemia; prognosis; peripheral blood cells 急性髓系白血病(AML)是最常见的急性白血病,随着对AML分子生物学#65380;遗传学研究的深 入,老年 AML与年轻患者存在明显的不同,具有独自的特征,年轻AML患者的治疗效果较好 ,但老年患者的预后仍不乐观。老年AML因合并症多#65380;化疗耐受性差等致使治疗相关死亡率 高,完全缓解(CR)率仅为45%,无病生存率(DFS)仅为20%,总的长期生存率不到10%[1]。 笔者回顾总结了1997~2008年期间我科收治老年AML患者67名,就不同外周血细胞计数与其 生存预后的关系进行分析研究,现报