96例急性淋巴细胞白血病患者的临床预后因素分析

Analysis of Prognostic Factors for 96 Patients with Acute Lymphoblastic Leukemia

目的:研究急性淋巴细胞白血病(ALL)患者的临床指标与疗效的相关性,以分析其预后意义。方法:选择2012年6月至2014年8月96例在我院诊治的96例ALL患者,记录患者的相关临床资料,主要包括年龄、外周血象、治疗方式和免疫分型等,并分析其与患者疗效的相关性。采用COX回归分析影响患者总生存时间(OS)和无疾病生存时间(DFS)的危险因素。结果:本研究纳入的96例ALL患者,第1个疗程治疗后65例患者获得完全缓解(CR),患者的年龄、免疫分型、中枢神经系统白血病(CNSL)、CD34表达和外周血白细胞计数与患者完全缓解相关(P<0.05)。单因素分析发现,年龄、白细胞(WBC)计数、血小板水平、免疫分型、巩固治疗是影响ALL患者的预后因素(P<0.05)。影响ALL患者2年OS率的独立因素为年龄大小、WBC计数、CD34表达及是否进行巩固治疗(P<0.05);ALL患者2年DFS率的独立因素是年龄大小、CD34表达和是否进行巩固治疗(P<0.05)。结论:年龄、WBC计数、CD34表达和缓解后是否进行巩固治疗是影响ALL患者的预后因素,对ALL临床治疗有指导意义。

Objective： To investigate the clinical characteristics and clinical prognostic factors of patients with acute lymphoblastic leukemia（ ALL）. Methods： Ninety-six ALL patients in our hospital from June 2012 to August 2014 were selected and their clinical data were collected. The related clinical data of patients were recorded,and the relation between clinical characteristics and therapeutic efficacy was analyzed. The COX analysis was used to reveal the risk factors affecting the patient ＇s OS and DFS time. Results： Among 96 ALL patients,65 patients achieved complete remission（ CR） after treatment. The age,immunophenotype,central nervous system leukemia（ CNSL） and peripheral blood WBC count correlated with complete remission（ P〈0. 05）. The age,WBC count,platelet level,immune typing and consolidation therapy were the prognostic factors（ P〈0. 05）,the 2 year OS rate was influenced by age,WBC count,CD34 and consolidation therapy（ P〈0. 05）,the 2 year DFS rate was influenced by age,CD34 and consolidation therapy（ P〈0. 05）. Conclusion： Age,WBC counts,CD34 and consolidated treatment after remission are prognostic factors for ALL patients,which has guiding significance for clinical treatment of ALL.