摘要
目的探讨影响急性髓系白血病伴t(8;21)患者生存、预后的主要因素。方法对87例急性髓系白血病伴t(8;21)患者进行总结分析、随访,了解临床一般情况、免疫分型、染色体核型及治疗、生存情况,分析影响总生存(OS)、无复发生存(RFS)的因素。结果86例完成诱导治疗的急性髓系白血病伴t(8;21)患者总完全缓解(CR)率95.3%,1个疗程CR率69.8%;采用含中剂量阿糖胞苷(Ara—C)方案诱导治疗的患者1个疗程CR率达86.2%,标准剂量Ara—C方案诱导治疗的患者1个疗程CR率60.3%。87例患者的中位OS期为16.4(0.3—121.5)个月,中位RFS期为11.7(1.9~116.3)个月;3年OS率42%,5年OS率39%,3年RFS率55%,5年RFS率55%。统计学分析显示,性别、染色体核型与OS有关,其中男性患者、染色体核型伴9q-的患者预后差、生存期短;诱导缓解治疗方案、巩固治疗方案、巩固治疗疗程数亦与OS有相关性,其中采用中剂量Ara—C诱导治疗、2个疗程以上中剂量Ara—C巩固治疗、完成4个疗程以上巩固治疗的患者预后好、生存期长。结论性别、染色体核型、诱导缓解及巩固治疗的方案是影响生存、预后的主要因素,在诱导、巩固治疗中应用中剂量Ara—C,可以明显提高1个疗程缓解率,延长OS、RFS期。
Objective To investigate the influence factors on survival and outcome of acute myeloid leukemia( AML) patients with t(8 ;21 ). Methods Eighty seven AML patients with t(8 ;21 )after long-term follow-up were enrolled in the analysis of clinical feature, immunophenotype, chromosome karyotype, treatment regimen, as well as the overall survival (OS) and relapse-free survival (RFS). Results The overall complete remssion (CR) rate was 95.3%. CR rate after first course therapy was 69.8% , after first course therapy containing medium dose Ara-C was 86.2% , and after first course of therapy containing standard-dose Ara-C was 60.3%. The median OS duration was 16.4 months, median RFS 11.7 months, 3 year OS rate 42% , 5 year OS rate 39% , 3 year RFS rate 55% and 5 year RFS rate 55%. Male gender chromsome 9q - had statistical significance for shorter OS and poor outcome, 2 courses of post -remission therapy with intermediate dose Ara-C, induction theray with intermediate-dose Ara-C and post-remission with 4 courses consolidation therapy had statistically longer OS and RFS. Conclusion Sex, chromosome karyotype, induction and consolidation therapy were important influence factors on OS and RFS. Application of intermediate dose Ara-C to induction and consolidation therapy leads to a higher CR rate, prolong OS and RFS.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2009年第3期186-191,共6页
Chinese Journal of Hematology
基金
863计划项目(2006AA02A405)
天津市基础研究计划重点项目(06YFJZJC02500)
关键词
白血病
非淋巴细胞
急性
易位
遗传
治疗
预后
Leukemia, nonlymphocytic, acute
Translocation, genetic
Therapy
Outcome