急性早幼粒细胞白血病89例临床特点与预后分析-内科学专业论文.docxVIP

中文摘要 中文摘要 ． 英文摘要 ． 研究论文 急性早幼粒细胞白血病89例临床特点与预后分析 前言月U舌 ?? ．．．． 33 材料与方法 4 结果 6 附图 8 附表 1 O 讨论 1 1 结论 16 参考文献 16 综述急性早幼粒细胞白血病的治疗历史与现状 20 致谢 35 个人简历 36 中文摘要急性早幼粒细胞白血病89例临床特点与预后分析 中文摘要 急性早幼粒细胞白血病89例临床特点与预后分析 摘 要 目的：观察分析急性早幼粒细胞白血病(APL)的临床特点，研究分 析影响长期生存的预后因素。 方法：对2007年7月至2009年7月间本院收治89例APL患者临床特点进 行分析，诱导缓解治疗采用全反式维甲酸(ATRA)联合亚砷酸(ATO)， 缓解后治疗采用常规剂量ATO和(或)ATRA与DA(柔红霉素+阿糖胞苷)， HA(高三尖杉酯碱+5可糖胞苷)，EA(依托泊甙邯可糖胞苷)方案交替进 行，总疗程持续3年，了解其完全缓解(CR)率、总体生存时间(0S)和无事 件生存时间(EFS)，并通过#检验，Log—Rank检验及Cox回归模型对可能影 响患者预后的因素进行统计学分析。 结果：双诱导缓解率达91．43％，83例(6例失访)患者总体生存率(OS) 为80．72％，其中初治外周血WBC10x 1 09／L者的OS为89．40％，WBC WBC≥_10x109／L OS为69．40％者(P0．05)，而两者OS有明显差异，与预后相 关。凝血功能异常也影响预后。 结论：ATO联合ATRA治疗APL可获得良好的疗效，对于初治白细胞 较高的患者，若初治能达到缓解并按期巩固治疗也有可能获得长期生存。 关键词：白血病；急性早幼粒细胞白血病；预后；生存分析 英文摘要Analysis 英文摘要 Analysis of Factors on Prognosis and Clinic characteristic about 89 cases of Acute Promyelocytic Leukemia ABSTRACT objective：To evaluate the Clinic characteristic，prognosis and long—term survival ofAPL patients． Methods：The 89cases of newly diagnosed APL patients from July 2007 to July 2009 were enrolled into this study．Induction treatment containing all—trans retinoic acid(ATRA)plus ATO，then followed by therapy with chemotherapy,containing DNR，homoharringtonine or etoposide plus Ara—C alternatively．The total period of treatment was 3 years．Univariate and multivariate analysis of the potential factors influencing survival of these patients was carried out by comparison of the cases in same stage with chi square test and Log—Rank and Cox regression methods．Prognostic indicators were demonstrated by CR rate，overall survival(os)and event—free survival (EFS)． Results：The complete remission rate achieved 9 1．43％，the estimated overall survival(OS)rate of 83(out search of 6)was 80．72％，The EFS rate of patients with WBC less than l Ox 1 09／L was 89．40％，which was higher than that with WBC greater than or equal to 1 0x 1 09／L 69．40％(P0．05)，and the OS rate had prominent difference．The abnormity function of cruor is poor prognostic factor