骨髓增生异常综合征转化为急性髓系白血病的危险因素分析

Risk factors for conversion of myelodysplastic syndrome to acute myeloid leukemia

目的探讨骨髓增生异常综合征转化为急性髓系白血病的危险因素。方法回顾性分析2016年3月至2018年2月佳木斯市中心医院收治的骨髓增生异常综合征患者98例的临床资料,统计骨髓增生异常综合征转化为急性髓系白血病情况,并对其发生的危险因素进行分析。结果98例骨髓增生异常综合征患者中转化为急性髓系白血病35例,转化率为35.71%。急性髓系白血病患者中年龄≥46岁、国际预后积分系统(IPSS-R)核型分组(预后差)、染色体核型(n≥3)及外周血3系白细胞减少所占比例均高于骨髓增生异常综合征者,差异有统计学意义(P<0.05)。经Logistic分析,年龄≥46岁、IPSS-R核型分组(预后差)、染色体核型(n≥3)及外周血3系白细胞减少是骨髓增生异常综合征转化为急性髓系白血病的危险因素(OR>1,P<0.05)。结论年龄≥46岁、IPSS-R核型分组预后差、染色体核型(n≥3)及外周血3系白细胞减少是骨髓增生异常综合征转化为急性髓系白血病的危险因素,应及时采取干预措施。

Objective To investigate the risk factors of myelodysplastic syndrome(MDS)transforming into acute myeloid leukemia(AML).Methods The clinical data of 98 patients with MDS admitted to the Jiamusi Central Hospital from March 2016 to February 2018 were retrospectively analyzed.The transformation of MDS into acute myeloid leukemia and its risk factors were analyzed.Results Among the 98 cases of MDS,35 cases were converted to acute myeloid leukemia,the conversion rate was 35.71%.The percentage of age≥46 years old,IPSS-R karyotype grouping(poor prognosis),chromosome karyotype(n≥3)and peripheral blood leukopenia in patients with acute myeloid leukemia were higher than those in patients with MDS(P<0.05).Logistic analysis showed that age(≥46 years old),IPSS-R karyotype grouping(poor prognosis),chromosome karyotype(n≥3)and peripheral blood leukopenia were risk factors for the transformation of MDS into acute myeloid leukemia(OR>1,P<0.05).Conclusions Age(≥46 years old),poor prognosis of IPSS-R karyotype grouping,chromosome karyotype(n≥3)and peripheral blood leukopenia are risk factors for the transformation of MDS into acute myeloid leukemia.Interventions should be taken in time.