急性髓系白血病患儿临床结局研究及预后相关因素分析

[Study of clinical outcome and analysis of prognosis related factor in children with acute myeloid leukemia].

作者信息

Zou Yao, Wang Hua, Chen Xiao-Juan, Wang Shu-Chun, Zhang Li, Chen Yu-Mei, Zhu Xiao-Fan

机构信息

Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2006 Sep;27(9):621-5.

PMID:17278430

Abstract

OBJECTIVE

To analyse the clinical outcome and the prognostic factor of childhood acute myeloid leukemia (AML).

METHODS

Disease-free survival (DFS), event-free survival (EFS) and overall survival (OS) rates were estimated by Kaplan-Meier method and prognostic factors were evaluated by Cox regression with SPSS in 141 childhood AML in our hospital from August 1995 to July 2004. The patients were divided into 2 groups: acute promyelocytic leukemia (APL) as group A and AML other than APL as group B.

RESULTS

Of the 90 group B patients, 54.4% (49/90) achieved complete remission (CR) after one course chemotherapy , with a total CR rate of 76.7%. The cumulative 5 year DFS and OS rate for group B patients were (28.4 +/- 9.0)% and (35.5 +/- 6.3)%, the 51 group A patients were (94.3 +/- 4.0)% and (81.4 +/- 5.7)%, and for total 141 AML patients were (56.9 +/- 6.3)% and (53.3 +/- 4.8)% respectively. Multivariate analysis demonstrated that higher bone marrow blast cell percentage at diagnosis, CR after more than one course of chemotherapy and less than six courses of consolidation chemotherapy were risk prognostic factors in childhood AML other than APL (P < 0.05).

CONCLUSION

The prognosis of childhood APL is better, while of childhood t(8;21) AML is no better than other FAB subtypes.

摘要

目的

分析儿童急性髓系白血病（AML）的临床结局及预后因素。

方法

采用Kaplan-Meier法估计无病生存期（DFS）、无事件生存期（EFS）和总生存期（OS）率，并使用SPSS软件通过Cox回归对1995年8月至2004年7月我院收治的141例儿童AML患者的预后因素进行评估。患者分为2组：急性早幼粒细胞白血病（APL）为A组，非APL的AML为B组。

结果

B组90例患者中，1个疗程化疗后54.4%（49/90）达到完全缓解（CR），总CR率为76.7%。B组患者5年累积DFS率和OS率分别为（28.4±9.0）%和（35.5±6.3）%，A组51例患者分别为（94.3±4.0）%和（81.4±5.7）%，141例AML患者总体分别为（56.9±6.3）%和（53.3±4.8）%。多因素分析表明，诊断时骨髓原始细胞比例较高、化疗超过1个疗程且巩固化疗少于6个疗程是儿童非APL AML的不良预后因素（P<0.05）。