骨髓病态造血对伴骨髓增生异常相关改变的急性髓系白血病患者的化疗疗效和生存预后作用研究

发布时间：2018-05-08 13:09

本文选题：病态造血 + 伴骨髓增生异常相关改变的急性髓系白血病　；参考：《浙江大学》2017年硕士论文

【摘要】：目的:分析骨髓病态造血对伴骨髓增生异常相关改变的急性髓系白血病患者的化疗疗效和生存预后作用。方法:收集浙江大学医学院附属第一医院2011年1月至2014年8月的伴骨髓增生异常相关改变的急性髓系白血病患者资料,包括患者的性别、年龄、染色体核型、突变基因、骨髓病态造血情况、既往MDS/MPN病史情况、诊断时血常规、诱导化疗方案、是否移植等,进一步对患者进行随访。分析骨髓病态造血对患者一疗程诱导化疗缓解率、总完全缓解率、总生存期、无事件生存期、无复发生存期等指标的作用。结果:共纳入112例患者,骨髓病态造血患者58例,骨髓无病态造血患者54例。二者在FAB分型、骨髓原始细胞数和WBC计数具有显著性差异(p0.05)。骨髓病态造血患者的一疗程诱导化疗完全缓解率34.9%,部分缓解率23.3%,骨髓无病态造血患者的一疗程诱导化疗完全缓解率23.7%,部分缓解率10.5%,二者无统计学差异(p=0.085)。骨髓病态造血组患者和骨髓无病态造血患者的总完全缓解率亦无显著性差异(55.3%vs 51.5%,p=0.752)。骨髓病态造血组与骨髓无病态造血组中位 OS(5.3 月 vs3.5 月,p=0.358)、EFS(4.3 月 vs3.4 月,p=0.467)和 RFS(13.7月 vs 6.0月,p=0.964)均无显著性差异。结论:骨髓有无病态造血对于伴骨髓增生异常相关改变的急性髓系白血病患者的化疗疗效和生存预后无显著性差异。
[Abstract]:Objective: to analyze the effect of chemotherapy and survival prognosis in patients with acute myeloid leukemia associated with abnormal myelodysplastic hematopoiesis. Methods: data of patients with acute myeloid leukemia associated with abnormal myelodysplasia were collected from the first affiliated Hospital of Zhejiang University School of Medicine from January 2011 to August 2014, including sex, age, chromosome karyotype and mutation gene. Bone marrow morbid hematopoiesis, past history of MDS/MPN, blood routine during diagnosis, induction chemotherapy, transplantation, etc., were followed up further. Objective: to analyze the effect of bone marrow morbid hematopoiesis on the remission rate, total complete remission rate, total survival time, event free survival and recurrence free survival of patients with one course of induced chemotherapy. Results: 112 patients, 58 patients with morbid hematopoiesis and 54 patients with no morbid hematopoiesis were included. There was significant difference in the number of bone marrow primordial cells and WBC count between the two groups in FAB typing (p 0.05). The complete remission rate of induced chemotherapy in patients with hematopoietic morbid bone marrow was 34.9, partial remission rate was 23.30.The complete remission rate of induced chemotherapy in patients with hematopoietic morbid bone marrow was 23.7and the remission rate was 10.50.There was no statistical difference between the two groups. There was no significant difference in the total complete remission rate between the morbid hematopoiesis group and the non-morbid hematopoietic group. There was no significant difference in the total complete remission rate between the patients with hematopoietic morbid bone marrow and those without hematopoiesis. There was no significant difference between the morbid hematopoiesis group and the bone marrow non-morbid hematopoietic group in the median vs3.5 month (0.358) and vs3.4 (0.467) and vs3.4 (0.964) in the vs3.4 month (13.7 months vs 6.0 months, respectively). Conclusion: there is no significant difference in chemotherapeutic effect and survival prognosis of patients with acute myeloid leukemia with or without abnormal hematopoiesis in bone marrow.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R733.71;R551.3

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