摘要
目的 :研究初发急性白血病 (AL)难治的相关因素 ,提高初发 AL 的早期完全缓解 (CR)率。方法 :对初发难治 AL 患者从 FAB分型、外周血常规、骨髓白血病细胞和治疗方案等方面进行回顾性对比分析。 结果 :135例初发 AL 中 36例经 2个疗程化疗未达 CR,难治率为 2 6 .7%。从 FAB分型来看 ,M4和 M5转化为难治性 AL 比率较高 ,分别为 47.1%、41.6 %。外周血常规中白细胞计数和白血病细胞百分率对疗效的影响较大 ,而血红蛋白、血小板和骨髓白血病细胞百分率在难治组和非难治组之间比较 ,差异无显著性。第 1疗程后外周血白细胞计数难治组显著高于非难治组 ,而 33.3%患者诱导缓解的化疗剂量低于标准剂量。结论 :M4和 M5型白血病、外周血白细胞计数和白血病细胞百分率增高以及化疗剂量不足是造成初发 AL 难治的重要因素。
Objective:To analyze the related factors for primary acute leukemia (AL) becoming refractory.Methods:Retrospective study was carried out on 36 patients with primary AL in terms of FAB classifications, peripheral blood(PB) cells, bone marrow(BM) leukemia cells and chemotherapy method.Results:Patients with AL(n=135) underwent 2 courses of chemotherapy, among which 36 patients could not reach complete remission, the refractory rate was 26.7%. Patients with M 4 and M 5, according to FAB classification, had more higher refratory rate than that in other subtypes, being 47.1% and 41.6% respectively.Peripheral white blood cell count and percentage of leukemia cells were major factors affecting treatment.Hemoglobin, platelets and percentage of leukemia cells in bone marrow had no significant difference between refractory and non-refractory groups.The lowest white blood counts after the first chemotherapy were higher in refractory patients than that in non-refractory patients.The doses of chemotherapy in 33.3% patients were lower than regular doses.Conclusion:M 4 and M 5 subtypes, peripheral white blood cell counts,percentage of leukemia cells increase and lower dose of chemotherapy are important factors for primary AL becoming refractory.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2002年第9期952-954,共3页
Academic Journal of Second Military Medical University
基金
上海市卫生系统百名跨世纪优秀学科带头人培养计划资助项目 (98BR0 2 9)
关键词
急性白血病
初发
难治
FAB分型
外周血
骨髓白血病细胞
治疗方案
acute leukemia
primary
refractory
FAB classification
peripheral blood
bone marrow leukemia cells
chemotherapy method
