急性早幼粒细胞白血病患者早期死亡原因探讨

Analysis of early death reason in patients with acute promyelocytic leukemia

目的 :探讨急性早幼粒细胞白血病 (APL)患者早期死亡原因。方法 :分析 12例早期死亡患者的临床资料。结果 :12例患者中 ,8例外周血白细胞大于 4 0× 10 9/L ,全部患者均检获t(15 ;17)及PML/RARα 基因 ,8例PML/RARα 基因为S型 ;9例死于DIC ,3例死亡与纤溶有关。结论 :具有高细胞负荷 ,FAB亚型为M3 b ,PML/RARα 基因为S型 ,未经ATRA诱导分化即开始联合化疗的APL易于早期死亡 ;并与DIC的发生和纤溶亢进有关。

Objective:To study the early death reason in patients with acute promyelocytic leukemia (APL).Method:Clincial and laboratory features and therapy regimen of 12 early death's patients with APL were Studied retrospective Ly.Result:Among 12 patients,WBCcounts was higher than 40×10 9/ L in 8 patients,abnormal Karyotype t(15;17)and PML/RAR α were found in all patients ,death reason was related with DIC in nine patients and that were related with fibrinolysis in three patients.Conclusion:APLpatients characterized by high WBC counts,M 3b(FAB diagnosis),PML/RAR α(S) and combined chemical therapy before differentiation therapy byATRA,were liable to early death.