Cervantes F, Sanz C, Bosch F, Rozman C
Escuela de Hematología Farreras Valenti, Servicio de Hematología, Hospital Clínico y Provincial de Barcelona.
Sangre (Barc). 1991 Jun;36(3):183-6.
The cause of death was revised in 109 cases of Ph'-positive chronic myelogenous leukaemia (CML) who died in a 15-year period. The median survival of the series, which included eight patients with initial criteria of blastic crisis, was 33.7 months (ranging between 2 and 192). Eight patients (7.3%) died during the chronic phase of the disease, 7 (6.4%) in the accelerated phase, and 94 (86.3%) in the blastic crisis. The cause of death in the chronic phase was frequently unrelated to CML (a second malignancy, cirrhosis of the liver, suicide, in four cases as opposed to infection, haemorrhage of hyperuricaemic renal failure in four others), but this was not so in the deaths occurred in the accelerated phase or blastic crisis. Thus, most of the deaths appearing in the accelerated phase were due to infection or haemorrhage, whereas in the blastic crisis they were mainly due to infection (54 of the 94 cases), followed by haemorrhage and leucostasis. All in all, these three complications were responsible for 94% of the deaths occurring in that evolutive phase of CML.
对15年间死亡的109例Ph'阳性慢性粒细胞白血病(CML)患者的死因进行了修订。该系列患者的中位生存期为33.7个月(范围在2至192个月之间),其中包括8例初始诊断为急变期的患者。8例患者(7.3%)死于疾病的慢性期,7例(6.4%)死于加速期,94例(86.3%)死于急变期。慢性期的死亡原因常与CML无关(4例为第二恶性肿瘤、肝硬化、自杀,另外4例为感染、高尿酸血症肾衰竭出血),但加速期或急变期死亡情况并非如此。因此,加速期出现的大多数死亡是由于感染或出血,而急变期主要是由于感染(94例中有54例),其次是出血和白细胞淤滞。总的来说,这三种并发症占CML该进展期死亡的94%。