血小板动态变化对MDS患者的预后影响

The Effect of Platelet Dynamic Changes on Prognosis of MDS Patients

目的:探讨初诊骨髓增生异常综合征(MDS)患者血小板动态变化与其预后的关系。方法:本研究收集了2009年1月—2021年12月于宁波大学附属第一医院就诊的200例MDS患者的临床资料,将半年内血小板计数(PLT)下降超过50%的患者定义为研究组(n=113),未超过50%的定义为对照组(n=87),通过分析对照组与研究组的临床实验室资料及生存情况,研究两组患者的临床特征和预后差异。结果:研究组初诊时血小板计数低于对照组,骨髓原始细胞比例高于对照组,IPSS-R分期高危与极高危组人数的比例高于对照组,总生存期及无白血病生存期显著低于对照组,并有更高的转白率,差异均有统计学意义(P<0.05)。结论:半年内血小板下降≥50%的MDS患者初诊时血小板计数更低,骨髓原始细胞比例更高,且具有更差的预后。

Objective:To investigate the relationship between platelet dynamic changes and prognosis in newly diagnosed MDS patients.Method:This study collected the clinical data of 200 MDS patients in the First Affiliated Hospital of Ningbo University from January 2009 to December 2021.The patients whose PLT decreased by more than 50%within half a year were selected as the study group(n=113),and those whose PLT decreased by less than 50%were defined as the control group(n=87).By analyzing the clinical laboratory data and survival conditions of the control group and the study group,the differences in clinical features and prognosis were studied between the two groups.Result:The platelet count of patients in the study group was lower than that in the control group at initial diagnosis,the proportion of bone marrow primitive cells was higher than that in the control group,the proportion of patients in the high-risk and extremely high-risk IPSS-R stage group was higher than that in the control group,the overall survival time and leukemia-free survival time of patients in the study group were significantly lower than the control group,and there was a higher rate of leukemic transformation,the differences were statistically significant(P<0.05).Conclusion:MDS patients with≥50%platelet decline within six months has lower platelet counts,and higher proportion of bone marrow primitive cells at first diagnosis,and a poorer prognosis.