Nahajevszky Sarolta, Kapás Balázs, Adám Emma, Lovas Nóra, Halm Gabriella, Gopcsa László, Tamáska Júlia, Poros Anna
Országos Gyógyintézeti Központ, Hematológiai és Immunológiai Intézet, Budapest.
Orv Hetil. 2004 Jan 25;145(4):167-72.
Treatment outcome in patients with acute myeloid leukemia are determined by prognostic factors.
Between January 1996 and December 2001 160 patients were treated with newly diagnosed acute myeloid leukemia. Treatment results were analysed according to the age and cytogenetics. Different types of induction and postremission protocols were applied. The median age was 42.2 +/- 12.8 (16-60) years.
Complete remission was reached in 113 (70.6%) patients. 25/160 (15.6%) individuals were refractory to treatment, 22/160 (13.8%) patients died within one month. One hundred and ten out of 113 who went into remission were given postremission therapy. Twelve out of 50 relapsed patients achieved a second complete remission. The complete remission rate and cumulative survival of patients below the age of forty years were significantly higher than of those above the age of 40 years. Four fifths of refractory patients as well as nearly all patients with secondary leukemia were older than 40 years. Similarly to studies published in the literature, the expected survival was the best in patients who had a favourable cytogenetics. In contrast, all patients who fell into the unfavourable cytogenetic group died within three years. Intensification of the postremission treatment resulted in an improved survival.
Classification of acute myeloid leukemia and careful determination of prognostic factors are necessary at the time of diagnosis. This predicts outcome, as well as provides means for application of individualized therapy.
急性髓系白血病患者的治疗结果由预后因素决定。
1996年1月至2001年12月期间,160例新诊断的急性髓系白血病患者接受了治疗。根据年龄和细胞遗传学分析治疗结果。应用了不同类型的诱导缓解和缓解后方案。中位年龄为42.2±12.8(16 - 60)岁。
113例(70.6%)患者达到完全缓解。25/160(15.6%)例个体对治疗耐药,22/160(13.8%)例患者在1个月内死亡。113例缓解患者中有110例接受了缓解后治疗。50例复发患者中有12例再次获得完全缓解。40岁以下患者的完全缓解率和累积生存率显著高于40岁以上患者。五分之四的耐药患者以及几乎所有继发性白血病患者年龄均超过40岁。与文献发表的研究相似,细胞遗传学良好的患者预期生存最佳。相反,所有细胞遗传学不良组的患者在3年内死亡。缓解后治疗的强化导致生存率提高。
急性髓系白血病的分类和预后因素的仔细确定在诊断时是必要的。这可预测治疗结果,并为个体化治疗的应用提供方法。