102例成人费城染色体阴性急性淋巴细胞白血病临床预后因素分析

秦晓璐; 葛晓燕; 李泽慧; 张彩霞; 张睿娟; 康建民; 杨林花

doi:10.13201/j.issn.1004-2806.2019.03.010

102例成人费城染色体阴性急性淋巴细胞白血病临床预后因素分析

- 1. 山西医科大学第二临床医学院(太原, 030001);
- 2. 山西医科大学第二医院血液科
基金项目:
山西省科技创新重点团队资助项目(No:201605D131044-05)

山西省卫生厅科研项目(No:201201082)

详细信息

通讯作者: 葛晓燕,E-mail:gxy4788@163.com

中图分类号: 733734.71

收稿日期: 2019-01-15

Analysis of clinical prognostic factors in 102 cases of adult Philadelphia chromosome-negative acute lymphoblastic leukemia

- 1. The Second Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China;
- 2. Department of Hematology, the Second Hospital of Shanxi Medical University

More Information

Corresponding author: GE Xiaoyan, E-mail: gxy4788@163.com

Received Date: 15 January 2019

摘要

摘要: 目的:分析成人费城染色体阴性(Ph)急性淋巴细胞白血病(ALL)患者的临床特征与疗效的关系。方法:收集102例成人Ph^--ALL患者的临床资料,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多因素回归模型分析影响患者总生存时间和无疾病生存时间的相关因素。结果:102例初诊Ph^--ALL患者中4周诱导化疗81例患者达CR,CR率79.41%,患者的发病年龄(P=0.022)、初诊时白细胞计数(P=0.003)、伴有肝脾/淋巴结肿大(P=0.034)、诱导化疗2周后骨髓原始细胞比例(P=0.003)是Ph^--ALL患者CR率的影响因素。81例达CR的患者中位生存时间为12个月,5年总生存率为32.11%,5年无疾病生存率为27.96%,COX多因素分析发现发病年龄(P=0.010)、初诊时白细胞计数(P=0.040)、4周诱导化疗达CR(P=0.010)为影响成人Ph^--ALL的独立预后因素。结论:发病时年龄、初诊时白细胞计数、诱导化疗4周达CR是影响成人Ph^--ALL患者的独立预后因素,积极接受异基因造血干细胞移植可以提高成人Ph^--ALL患者的疗效。
- 费城染色体 /
- 成人急性淋巴细胞白血病 /
- 临床特征 /
- 总生存 /
- 无病生存
Abstract: Objective:To analyze the relationship between clinical characteristics and curative effect in adult patients with Philadelphia (Ph) chromosome negative acute lymphoblastic leukemia (ALL).Method:The clinical data of 102 patients with adult Ph^--ALL were analyzed retrospectively.The relationship between clinical characteristics and curative effect was analyzed.The COX analysis was used to reveal the risk factors affecting the patients' overall survival and disease-free survival time.Result:Among 102 Ph^--ALL patients,81 patients (79.41%) achieved complete remission (CR) after treatment.The age of onset (P=0.022),the number of white blood cells at initial diagnosis (P=0.003),the enlargement of lever spleen and lymphomode (P=0.034) and bone marrow blasts ratio after induction chemotherapy for 2 weeks (P=0.003) were the factors influencing the CR rate in patients with Ph^--ALL.The median survival time of 81 patients with CR was 12 months,the overall survival rate in 5 years was 32.11% and the disease-free survival rate in 5 years was 27.96%.COX multi-factor analysis showed that the age of onset (P=0.010),the number of white blood cells at the beginning of the initial diagnosis (P=0.040) and 4 weeks of induced chemotherapy amounted to CR (P=0.010) were independent prognostic factors affecting adult Ph^--ALL patients.Conclusion:Age at the time of onset,the number of white blood cells at initial diagnosis and induction chemotherapy 4 weeks up CR are independent prognostic factors affecting adult Ph^--ALL patients.Active acceptance of allogeneic hematopoietic stem cell transplantation can improve the curative effect of adult Ph^--ALL patients.
- Philadelphia chromosome /
- adult acute lymphoblastic leukemia /
- clinical characteristics /
- overall survival /
- disease free survival

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参考文献(7)

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