Ph染色体阳性慢性粒细胞白血病患者多因素预后分析

Multivariate analysis of prognostic factors in Philadelphia chromosome-positive chronic granulocytic leukemia

目的 探讨影响Ph阳性慢性粒细胞白血病 (CGL)患者生存期的因素。方法 对 2 0 9例CGL患者的临床体征、血常规和骨髓象进行单因素预后分析 ,然后对有意义的单因素用COX回归模型进行多因素综合分析。结果 2 0 9例患者中位生存时间 5 7个月 (3～ 179个月 ) ,5年生存率 48%。经COX回归多因素综合分析 ,外周血原始粒细胞、早幼粒细胞、出现有核红细胞、骨髓原始粒细胞 (≥0 0 4)为影响生存期的 4个主要因素。依评分指数公式分为低危、中危和高危组 ,中位生存时间分别为76 .0 ,5 6 .0和 31.5个月 (P <0 .0 1) ,5年生存率分别为 70 .42 %、46 .30 %和 18.18% (P <0 .0 1)。结论 提出适合我国CGL患者的预后评分指数公式。目的 探讨影响Ph阳性慢性粒细胞白血病 (CGL)患者生存期的因素。方法 对 2 0 9例CGL患者的临床体征、血常规和骨髓象进行单因素预后分析 ,然后对有意义的单因素用COX回归模型进行多因素综合分析。结果 2 0 9例患者中位生存时间 5 7个月 (3～ 179个月 ) ,5年生存率 48%。经COX回归多因素综合分析 ,外周血原始粒细胞、早幼粒细胞、出现有核红细胞、骨髓原始粒细胞 (≥0 0 4)为影响生存期的 4个主要因素。依评分指数公式分为低危、中危和高危组 ,中位生存时间分别为76 .0 ,5 6 .0和 31.

Objective To investigate the prognostic factors of the patients with Philadelphia chromosome positive chronic granulocytic leukemia(CGL). Methods Clinical and laboratory parameters of 209 CGL patients at diagnosis were analyzed in relation to survival. COX regression analysis were used to identify the statistically significant prognostic factors. Results The median survival time was 57(3～179)months, and 5 year survival rate was 48%. From the COX regression model, the four main poor prognostic factors were as follows: percentage of bone marrow blasts(≥0.04), percentage of peripheral blood blasts and promyelocytes and presence of erythroid precursors in peripheral blood. According to the prognostic scores, three groups of CGL were identified. The low risk group was with a median survival time of 76 months, the intermediate risk group with 56 months, and the high risk group with 31.5 months(P<0.01). The 5 year survival rate was 70.42%,46.30% and 18.18%(P<0.01),respectively. Conclusions A prognostic scoring system suitable for Chinese CGL patients was proposed.