Boma P O, Durosinmi M A, Adediran I A, Akinola N O, Salawu L
Department of Haematology, Federal Medical Centre, and Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria.
Niger Postgrad Med J. 2006 Mar;13(1):47-52.
Chronic myeloid leukemia (CML).
CML patients confirmed at the OAUTHC, Ile-Ife between June 1986 and December 1999 were studied prospectively until death or the last visit to the clinic. Stages of the disease at diagnosis, presenting clinical features and laboratory parameters, as well as the drug history were noted for each patient. Survival of each patient was computed from the date of diagnosis until the date of death. Kaplan-Meier statistical technique was used for analysis of survival. Factors were compared with log rank test. Student's t-test was used for comparing means of presenting clinical and laboratory parameters between groups. P-value of <0.05 was considered significant. SPSS for windows Release 10 (Real Stats, Real Easy, 1989-1999) was used for all calculations.
There were 42 patients (27 males and 15 females, ratio of 1.8:1) with ages ranging from 12-74 (median=38.0) years. Philadelphia chromosome was positive in the five patients (12.0%) that underwent cytogenetic analysis. Thirty-three of the patients (78.6%) presented in treatable chronic phase and the other 9 (21.4%) were seen in advanced stages (7 in accelerated & 2 in blastic phase). The median survival of patients that presented in chronic phase was 31.7 months compared to 0.16 months in patients presenting in advanced stages, the difference was statistically significant (log rank=7.8, p-value=0.005). Significant positive correlation was obtained between spleen size and total white cell count at diagnosis (r=0.36, p=0.02). Univariate regression analysis showed negative relationship between survival and ages of patients at diagnosis, haematocrit value, spleen and liver sizes, and blast count. The relationships were statistically significant for only liver and spleen (b=-0.63, p=0.004 and b=-0.51, p=0.026, respectively). Regression of both the liver and spleen with survival, still confirms the significant negative relationship between hepatomegaly and survival.
慢性髓性白血病（CML）。
对1986年6月至1999年12月期间在伊费岛奥乌斯教学医院确诊的CML患者进行前瞻性研究，直至死亡或最后一次就诊。记录每位患者诊断时的疾病分期、临床表现和实验室参数以及用药史。计算每位患者从诊断日期到死亡日期的生存期。采用Kaplan-Meier统计技术分析生存期。采用对数秩检验比较各因素。采用学生t检验比较各组临床表现和实验室参数的均值。P值<0.05被认为具有统计学意义。所有计算均使用Windows版SPSS 10（真实统计，轻松上手，1989 - 1999）。
共有42例患者（男性27例，女性15例，比例为1.8:1），年龄在12 - 74岁（中位数 = 38.0岁）之间。接受细胞遗传学分析的5例患者（12.0%）费城染色体呈阳性。33例患者（78.6%）处于可治疗的慢性期，另外9例（21.4%）处于晚期（加速期7例，急变期2例）。慢性期患者的中位生存期为31.7个月，而晚期患者为0.16个月，差异具有统计学意义（对数秩 = 7.8，P值 = 0.005）。诊断时脾脏大小与白细胞总数之间存在显著正相关（r = 0.36，P = 0.02）。单因素回归分析显示，生存期与诊断时患者年龄、血细胞比容值、脾脏和肝脏大小以及原始细胞计数呈负相关。仅肝脏和脾脏的相关性具有统计学意义（分别为b = -0.63，P = 0.004和b = -0.51，P = 0.026）。肝脏和脾脏大小与生存期的回归分析仍证实肝肿大与生存期之间存在显著负相关。
