应用生存分析寻找急性髓性白血病治疗前和治疗反应预后因素

IDENTIFICATION OF PROGNOSTIC FACOSTICFACTORSIN PRETKEATMENT AND TREATMENT-KESPON-SE IN ACUTE MYELOID LEUKEMIA BY SURVIVAL ANALYSIS

对１２８例急性髓性白血病患者的化疗前和化疗反应因素的研究表明，诱导化疗反应比化疗前因素的预后意义更突出。影响缓解的因素包括年龄、脾肿大、诱导期血小板低于６０×１０￣９／Ｌ日数比例（ｐＣ＜６０日数比）、诱导期体温高于３８℃日数比例（体温＞３８日数比）和白细胞低于１×１０￣９／Ｌ日数比例（ＷＢＣ＜１日数比）。影响生存的因素则是诱导期平均最低白细胞计数、ＭＢＤＩ、ＰＣ＜６０日数比和体温＞３８日数比。ＰＣ＜６０日数比比ＷＢＣ＜１日数比更明显地与诱导化疗剂量相关。对诱导化疗反应良好的特征为ＭＢＤＩ＞６０％、平均为１４％的ＷＢＣ＜１日数比以及ＰＣ＜６０日数比＜２０％。

adult patients with acute myeloid leukemia(AML)were studied to determinethe pretreatment and treatment-response factors(pre-TFs and TRFs)in order to attain com-plete remission (CR)and survival.The result demonstrate that the TRFs are more significantthan the pretreatment clinic feautures in predicting the outcome of AML.There are several fac-tors-age,spleen enlargement,ratio of the days when the blood platelet counts decrease below 60×109/L(RDBPCU60),white blood cell cunts(WBC) below 1× 109/L(RDWBCUI)andbody temperature above 38℃(RDPTO38)to the days of induction therapy-showing their sig-nificance on the attainment of CR,while the average of the lowest WBC during induction,mar-row blast depressing index(MBDI),RDBPCU60 and RDPTO38 demonstrate their importancebsurvival among the pre一TFs and TRFs.Further more,RDBPCU60 shows more significantrelation ship to the induction dosage than RD WBCU1.The patients who responded to induc-tion are characterized by MBDI> 60%,average RDwBCU114% and RDBPCU60< 20%.