Lynch R E, Williams D M, Reading J C, Cartwright G E
Blood. 1975 Apr;45(4):517-28.
The biphasic shape of the survival curve of 99 patients with aplastic anemia suggested that there may be at least two subgroups of patients with this disease, one with a very short survival and another with a longer survival. Patients who survived for 4 mo or less after the first clinic visit (group A) were different from the patients who survived longer (group B) with respect to their modes of onset, sex, intervals from the onset of symptoms to first clinic visit, and initial hematologic values. These differences suggested that short survival could be predicted from data available at the first contact with the physician. From these measurements, a prognostic index could be calculated which was useful in identifying the patients in group A. Although this method of prognostication needs further testing, if validated, it may prove useful in selecting patients for therapeutic trials and could explain the divergent results in previous studies of androgen treatment of aplastic anemia. When our androgen-treated subjects were compared with subjects with a similar prognostic index who had not received androgens, a beneficial effect of androgen therapy on survival could not be demonstrated.
99例再生障碍性贫血患者生存曲线的双相形态提示，该疾病患者可能至少存在两个亚组，一组生存时间极短，另一组生存时间较长。首次就诊后存活4个月及以内的患者（A组）与存活时间较长的患者（B组）在起病方式、性别、症状出现至首次就诊的间隔时间以及初始血液学值方面存在差异。这些差异表明，根据首次与医生接触时可得的数据可以预测短期生存情况。通过这些测量，可以计算出一个预后指数，该指数有助于识别A组患者。尽管这种预后方法需要进一步验证，但如果得到证实，它可能在选择患者进行治疗试验方面有用，并且可以解释先前雄激素治疗再生障碍性贫血研究中结果的差异。当将我们接受雄激素治疗的受试者与具有相似预后指数但未接受雄激素治疗的受试者进行比较时，未证明雄激素治疗对生存有有益影响。
