61例成人急性淋巴细胞白血病患者的临床特征和疗效分析

发布时间：2018-01-27 07:47

本文关键词： 成人急性淋巴细胞白血病临床特征疗效分析　出处：《中国实验血液学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:探讨成人急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)患者的临床特征与疗效的关系。方法:回顾性分析2010年1月至2014年12月东南大学附属中大医院血液科连续收治的≥15岁的61例ALL患者临床资料。分析患者的临床和生物学特征与完全缓解率(CR)的关系。用COX回归进行与总生存时间(overall survival,OS)和无疾病生存时间(disease free survival,DFS)有关的危险因素的单因素和多因素分析。结果:61例患者经1个疗程诱导化疗后44例获得CR,总CR率72.13%。发病时年龄、初诊时外周血白细胞计数、初诊时有无CNS-L、髓系抗原表达、Ph染色体情况等均是影响诱导缓解率的重要因素(P0.05)。61例患者2年OS率为28.13%,中位生存期为11个月(95%CI 9.58-12.42)。44例获得CR的患者中,2年OS率为39.57%,2年DFS率为34.29%。单因素分析显示,患者的发病年龄、初诊时WBC计数、诱导缓解是否达到CR、在CR后是否接受巩固治疗或异基因HSCT治疗,均为影响成人ALL的预后因素。多因素分析显示,发病时高龄(P=0.001)、诱导化疗未达到CR(P=0.018)及CR后未进行巩固治疗(P=0.027)是影响OS的独立危险因素;诱导化疗未达到CR(P=0.002)及CR后未进行巩固治疗(P=0.005)是影响DFS的独立危险因素。结论:成人ALL化疗的CR率高,但总OS率低,争取CR及在CR后继续巩固维持治疗可提高长期生存率。
[Abstract]:Objective: to study the acute lymphoblastic leukemia of adult acute lymphoblastic leukemia (ALL). ALL). Relationship between clinical characteristics and efficacy of patients. Methods:. The clinical data of 61 ALL patients aged more than 15 years who were admitted to the Department of Hematology of affiliated Hospital of Southeast University from January 2010 to December 2014 were retrospectively analyzed. The clinical and biological characteristics of the patients were analyzed. And complete remission rate (. COX regression and total survival time (survival). And disease free free survival. Results after one course of induction chemotherapy, 44 cases of CRR were obtained, and the total CR rate was 72.13%. The age at the time of onset was 72.13%. The leukocyte count in peripheral blood at first visit, CNS-Land myeloid antigen expression in the first visit. Ph chromosome was an important factor affecting the induced remission rate. The 2-year OS rate was 28.13% in 61 patients. The median survival time was 11 months and 95 CI 9.58-12.42. 44 patients received CR, the 2-year OS rate was 39.57%. The DFS rate of 2 years was 34.29.The univariate analysis showed that the age of onset, the number of WBC at first visit, and whether the induced remission reached CR. Whether or not to receive consolidation therapy or allogeneic HSCT therapy after CR was the prognostic factor of adult ALL. Multivariate analysis showed that the elderly patients at the time of onset of the disease were P0. 001). Induction chemotherapy did not reach CRP 0.018) and did not undergo consolidation therapy after CR (P0. 027) were independent risk factors affecting OS. Conclusion: the CR rate of adult ALL chemotherapy is higher than that of the adult patients with ALL (P < 0. 002) and no consolidation therapy after CR (P 0. 005) is an independent risk factor for DFS. However, the overall OS rate was low. Long-term survival rate could be improved by striving for CR and continuing to consolidate and maintain therapy after CR.
【作者单位】：东南大学医学院附属中大医院血液科;
【分类号】：R733.71
【正文快照】： J Exp Hematol 2017;25(3):711-717急性淋巴细胞白血病(acute lymphoblasticleukemia,ALL)是一种起源于B系或T系淋巴祖细胞的造血干细胞异常克隆性疾病,在临床、细胞遗传学及分子生物学均具有高度异质性,约占所有成人急性白血病的15%-20%[1]。目前儿童ALL单纯化疗的完全缓解率

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