摘要
目的 :探讨急性白血病患者预后的主要影响因素 ,为改善患者的预后 ,延长生存期提供临床依据。方法 :对本院 89例治疗和随访的成人急性白血病患者 ,以Kaplan Meier法描述生存曲线 ,用对数秩检验 (Log rank)进行单因素分析 ,并收集可能影响预后的 31个因素的全部资料 ,运用Cox回归模型进行回顾性统计分析。结果 :89例患者中 ,急性髓细胞性白血病 (AML)和急性淋巴细胞性白血病 (ALL) 0、1、2、3、4、5年生存率分别为6 9 .75 %、4 9.33%、32 .32 %、18.71%、13.6 %、10 .80 %和 6 5 .38%、5 3.85 %、4 6 .15 %、30 .77%、15 .38%、15 .30 % ,有15例达 5年以上长期生存 ,总的 5年长期生存率为 14 .4 % ,急性早幼粒细胞白血病 (M3)的长期生存率较其他类型高。初诊时外周血白细胞小于 30× 10 9/L、乳酸脱氢酶 (LDH)正常、第 1次化疗诱导缓解及最终达缓解、缓解后有巩固治疗的患者生存时间较长。结论 :急性白血病 5年长期生存率为 14 .4 % ,M3预后较好 ,外周血白细胞、LDH、第 1次诱导是否缓解、最终缓解情况、有否巩固治疗是影响长期生存的主要预后因素。
Objective:To sum up the prognostic factors in acute leukemia in our hospital. Methods: 89 acute leukemia patients in our hospital were received and followed up. Using Kaplan-Meier method to describe the survival curve, a univariate and a multivariate analysis of 31 possible factors influencing survival of these patients were carried out. The prediction of survival rates was established by Cox regression model. Results: The 0,1,2,3,4,5 year survival rate of the 89 patients:were 69.75%,49.33%,32.32%,18.71%,13.6%,10.80% in AML,respectively;ALL 65.38%,53.85%,46.15%,30.77%,15.38%,15.30% in ALL,respectively.Among them 15 patients had 5-year long-term survial, the rate was 14.4% for all the cases. Long-term survival of acue progranulocytic leukemia was higher than that of other types. The media survival time was longer in the group with peripheral leukocyte <30×109/L, normal lactic hydrogenase(LDH), first regimen achieving complete remission, finally complete remission and the consolidation therapy. Conclusions: The 5-year long-term survival rate for acute leukemia was 14.4 %,acute progranulocytic leukemia(M3)had better prognosis.Peripheral leukocyte, LDH,complete remission by the first regiment,finally complete remission and the strengthen therapy were highly associated with long-term survival.
出处
《广州医学院学报》
2004年第3期58-62,共5页
Academic Journal of Guangzhou Medical College
基金
广州市科技局科技攻关重点项目资助(NO 2 0 0 2z2 -E0 2 4 1)
关键词
急性白血病
生存分析
影响因素
acute leukemia
survival analysis
affecting factors
