急性T淋巴细胞白血病23例临床分析

T-cell acute lymphocytic leukemia:clinical analyses of 23 cases

目的探讨急性T淋巴细胞白血病患者的近期疗效、预后及预后相关因素。方法回顾性分析2013年1月至2018年12月上海交通大学医学院附属瑞金医院北部院区收治的23例初发急性T淋巴细胞白血病患者临床资料,并结合文献对其临床特征、治疗及转归进行总结。结果23例患者中,男性14例,女性9例,中位年龄32岁(14~58岁)。诱导治疗采用标准VDPCP方案,总有效率为60.9%(14/23),完全缓解率为47.8%(11/23),部分缓解率为13.0%(3/23);中位无进展生存时间为11.5个月(0~66.0个月),中位总生存时间为15.4个月(2.0~66.0个月)。与诱导缓解相关的可评价预后因素包括年龄、初发时白细胞计数、NOTCH1基因突变、染色体核型及疾病特殊类型,但差异均无统计学意义(均P>0.05)。结论急性T淋巴细胞白血病患者预后较差,初次诱导缓解率低,无进展生存时间和总生存时间短。

Objective To investigate the effectiveness,prognosis and prognostic factors of patients with T-cell acute lymphocytic leukemia.Methods The clinical data of 23 patients with newly diagnosed T-cell acute lymphocytic leukemia from January 2013 to December 2018 in North District of Ruijin Hospital Affiliated to Medical School of Shanghai Jiaotong University were retrospectively analyzed,and their clinical characteristics,treatment and prognosis were summarized combined with literature.Results Among 23 patients,14 were males and 9 were females,with a median age of 32 years old(14-58 years old).The induction therapy adopted standard VDPCP regimen.The overall response rate was 60.9%(14/23),the complete remission rate was 47.8%(11/23),the partial remission rate was 13.0%(3/23),the median progression-free survival time was 11.5 months(0-66.0 months),and the median overall survival time was 15.4 months(2.0-66.0 months).The evaluable prognostic factors associated with induction remission included age,white blood cell count at the time of onset,NOTCH1 gene mutation,chromosome karyotype,and specific types of disease,but the differences were not statistically significant(all P>0.05).Conclusion The prognosis of patients with T-cell acute lymphocytic leukemia is poor,the remission rate of initial induction is low,the progression-free survival time is short,and the overall survival time is short as well.