急性红白血病64例生物学特点及预后分析

Biological characteristics and prognosis analysis of 64 cases of acute erythroid leukemia

目的:探讨急性红白血病的生物学特点并对预后进行评价。方法:回顾分析2001-07—2011-07的64例急性红白血病患者,针对其形态学、免疫学、细胞遗传学和分子生物学(MICM)特征及生存期进行分析。采用病例对照方法,分为原发组和骨髓增生异常综合征(MDS)转化组,针对2组患者化疗和异基因造血干细胞移植(Allo-HSCT)治疗的疗效和生存预后分析。结果:原发组缓解率为62%(24/39),MDS转化组缓解率为47%(8/17),2者间差异无统计学意义(P>0.05)。染色体核型异常组和正常组的缓解率分别为41%(10/24)和69%(22/32),2者间差异有统计学意义(P<0.01)。MDS转化组17例,化疗与移植1年总生存率(OS)分别为25.0%和88.9%,差异有统计学意义(P<0.01)。染色体核型异常组24例,化疗与移植组1年OS分别为25.0%和85.6%,差异有统计学意义(P<0.01)。结论:64例患者中常规化疗疗效差、生存期短、预后差,Allo-HSCT显著延长生存期,改善预后,染色体核型异常患者诊断后宜早期行Allo-HSCT。

Objective：To evaluate the prognosis and the biological characteristics of acute erythroid leukemia.Method：The data of 64cases of acute erythroid leukemia which were treated in our hospital between July 2001and July 2011were retrospectively analyzed.The feature of morphology,immunology,cytogenetics,molecular biology（MICM）and survival time were analyzed.Case-control method was used,and all cases were divided into two groups,namely primary group and myelodysplastic syndromes（MDS）transform group.The two groups were analyzed by comparing the treatment effect of chemotherapy and allogeneic hematopoietic stem-cell transplantation（Allo-HSCT）,and survival prognosis.Result：The remission rate of primary group and MDS transform group was 62%（24/39）and 47%（8/17）,respectively,and there were no statistically significant difference（P〉0.05）.The remission rate of chromosome abnormalities group and normal group was 41%（10/24）and 69%（22/32）,respectively,and there was a statistically significant difference（P〈0.01）.The one year overall survival rate（OS）of chemotherapy and Allo-HSCT in MDS transform group including 17cases was 25%and 88.9%,respectively,are there were a statistically significant difference（P〈0.01）.The one year overall survival rate（OS）of chemotherapy and Allo-HSCT in chromosome abnormalities group including 24cases was 25% and 85.6%,respectively,and there was a statistically significant difference（P〈0.01）.Conclusion：In the 64cases,chemotherapy often had poor treatment effect,short survival time and poor prognosis,meanwhile Allo-HSCT could increase survival time and improve prognosis,chromosome abnormalities patients should perform early Allo-HSCT.