急性髓系白血病患者伊达比星联合阿糖胞苷化疗预后的相关因素

The influencing factors on the prognosis of patients with AML after chemotherapy by idarubicin combined with cytarabine

目的分析急性髓系白血病(AML)患者经伊达比星联合阿糖胞苷(IA方案)化疗治疗预后的影响因素。方法回顾性分析,收集2018年12月至2020年3月广西壮族自治区南溪山医院收治的经IA方案化疗且完成12个月随访的57例预后不良AML患者资料,纳入预后不良组;收集同期医院收治的经IA方案化疗且完成12个月随访的57例预后良好的AML患者资料,纳入预后良好组。查阅患者病历资料,统计并比较2组患者基线资料,分析AML患者经IA方案化疗治疗预后的影响因素。结果预后不良组患者初始白细胞计数(WBC)、内皮细胞生长因子(VEGF)水平高于预后良好组,CD11b阳性、CD34阳性、Fms样酪氨酸激酶-3-内部串联复制(FLT-3-ITD)突变型占比高于预后良好组,差异有统计学意义(P<0.05);组间其他资料比较差异无统计学意义(P>0.05);经Logistic回归分析显示,初始WBC高水平、VEGF高水平、CD11b阳性、CD34阳性、FLT-3-ITD突变型是AML患者经IA方案化疗治疗预后不良的危险因素(OR>1,P<0.05)。结论AML患者经IA方案化疗治疗预后不良可能受初始WBC、VEGF水平、免疫表型、基因突变类型的影响。

Objective To investigate the influencing factors on the prognosis of patients with acute myeloid leukemia(AML)after chemotherapy by idarubicin combined with cytarabine(IA scheme).Methods The clinical data about 114 patients with AML who were treated by IA scheme and followed up for 12 months in our hospital from December 2018 to March 2020 were retrospectively analyzed,who were divided into good prognosis group and poor prognosis group,with 57 cases in each group.The baseline data of patients and the influencing factors on the prognosis of patients were observed and compared between the two groups.Results The levels of initial white blood cell count(WBC),endothelial growth factor(VEGF)and the proportion of CD11b positive,CD34 positive,FMS like tyrosine kinase-3-internal tandem replication(FLT-3-ITD)mutation in poor prognosis group were significantly higher than those in good prognosis group(P<0.05),however,there were no significant differences in the other data between the two groups(P>0.05).Logistic regression analysis showed that the higher levels of WBC,VEGF,CD11b,CD34 and FLT-3-ITD mutation were the risk factors resulting in the poor prognosis of patients(OR>1,P<0.05).Conclusion The poor prognosis of patients with AML after chemotherapy(IA scheme)may be affected by the initial WBC,VEGF level,immunophenotype and gene mutation type.