难治性急性白血病的化疗方案选择及其危险因素的Logistic回归分析

The chemotherapy choice of refractory acute leukemia and logistic regression of its risk facts

目的 :对难治性急性白血病选择不同强度的化疗方案 ,评价疗效 ,对其危险因素进行多元回归分析。方法 :对 4 5例难治性急性白血病 ,根据其临床特点 ,分别选择普通强度化疗方案和强化化疗方案 ,详细分析对其化疗方案选择的危险因素并进行Logistic多元回归分析。 结果 :普通强度化疗组 2 1例中 ,4例完全缓解 (CR) ,CR率为 19.0 5 % ,强化化疗组 2 4例中 ,8例CR ,CR率为 33.33%。经统计学分析 ,普通强度化疗组与强化化疗组治疗相比 ,两组差异有统计学意义 (P <0 .0 5 ) ,说明强化化疗组治疗效果优于普通强度化疗组。在对其化疗效果的影响的危险因素的多元回归分析中 ,对治疗效果有影响的是复发次数 ,复发时白细胞计数异常 ,髓外浸润 ,并发症 ,其均P <0 .0 5。结论 :在对难治性急性白血病的治疗过程中 ,要对复发次数多 ,复发时白细胞计数异常 ,髓外浸润 ,并发症严重程度作出相应分析和判断 。

Objective:To analyse the clinical characteristics of refractary acute leukemia and to choose different intensive chemotherapy, and to analyse their risk factors by Logistic regression.Method:45 cases of diagnosed refractary acute leukemia of patients ages between 1 to 60 were observed in the study, including 13 cases between 1 to 12 years old, and 32 cases between 13 to 60 years old. Infection, bleeding, anemia and out-myeloid impinging were the most common manifestation found. We divide 45 cases into 2 groupings depending on the intensity of chemotherapy: the common intensive chemotherapy, the outstanding intensive chemotherapy. Their risk factors was analyzed by Logistic regression.Result:Among 45 patients, the common intensive chemotherapy grouping 21 cases, 4 patients achieved CR (CR rate 19.5%); the outstanding intensive chemotherapy grouping 24 cases, 8 patients achieved CR (CR rate 33.33%). According to the statistcal analysis, showed more effective than the common intensive chemotherapy grouping. Logistic regression showed that relapse times, the count of WBC, out-bone marrow infiltration and complication were the risk factors for the effect of refractory acute leukemia.Conclusion:Relapse acute leukemia has its special clinical appearances, and the treatment strategy should be made depending on relapse times, the count of WBC, out-bone marrow infiltration and complication.