摘要
目的:分析急性单核细胞白血病的临床、生物学特征和生存、预后。方法:对183例患者的临床资料进行总结,了解一般情况、免疫分型、染色体核型、治疗、生存等情况。结果:①158例患者行诱导化疗,完全缓解(CR)率74.1%,初次诱导应用mHAD者CR率(86.2%),明显高于其他方案诱导者(62.8%);②161例行染色体核型分析,正常核型占55.9%;未见分裂象6例;异常核型40.4%,涉及11q(23)、+8、9q/del(9q)、复杂核型等,核型正常者CR率明显高于核型异常者,预后中等组患者CR率,1年、3年OS及DFS率明显好于预后差组,但与意义未知组患者无明显差别。③CR的患者采用含ID-Ara-C诱导及巩固治疗组,1年、3年OS及DFS率明显优于标准剂量Ara-C诱导及巩固治疗组。巩固治疗≥2疗程者明显优于巩固治疗1疗程者。④COX多因素分析显示,染色体核型、CD11b的表达、巩固治疗疗程数对生存有显著的影响。结论:M5核型以预后差者多见,含中剂量Ara-C的诱导及巩固治疗组治疗可提高生存率,染色体核型、CD11b表达及巩固治疗的疗程数明显影响患者的生存。
Objective：To analyze the clinical and biological characteristics and prognosis of acute monocytic leukaemia.Method：183 patients were enrolled.Clinical feature,immunophenotype,chromosome karyotype,therapy and survival were analyzed.Result：①158 patients received induction therapy.The complete remission（CR） rate was 74.1%.And CR rate was higher in the patients who received mHAD than the others.②Normal and abnormal chromosome karyotypes accounted for 55.9% and 40.4%,respectively.The CR rate,OS and DFS rates in intermediate prognostic group were higher than in poor prognostic group,but there was no difference between intermediate prognostic group and unknown group.③The OS and DFS rates of the CR patients who received intermediate dose Ara-C were higher than those who received standard dose Ara-C for induction and consolidation therapy.Patient who received two or more courses of consolidation therapy may have a better survival.④Chromosome karyotype,CD11b（＋） and the course of consolidation therapy had more important influence on survival by COX analysis.Conclusion：Poor prognostic karyotypes were common in M5,intensive chemotherapy（including induction chemotherapy and post-remission chemotherapy） can improve prognosis of AML-M5.Chromosome karyotype,CD11b（＋） and the course of consolidation therapy had important influence on survival.
出处
《临床血液学杂志》
CAS
2010年第5期536-539,共4页
Journal of Clinical Hematology
