高身体质量指数是急性早幼粒细胞白血病患者分化综合征的独立预测因子。

High body mass index is an independent predictor of differentiation syndrome in patients with acute promyelocytic leukemia.

机构信息

Department of Hematology, Aziza Othmana University Hospital, Tunis, Tunisia.

出版信息

Leuk Res. 2010 Apr;34(4):545-7. doi: 10.1016/j.leukres.2009.09.017. Epub 2009 Oct 1.

DOI:10.1016/j.leukres.2009.09.017

PMID:19800119

Abstract

Increased BMI has been correlated to an increased incidence of APL, but not to the occurrence of differentiation syndrome (DS) in APL. We consecutively treated 39 APL patients with ATRA and idarubicin (according to PETHEMA regimen). Median age was 26 years. Forty-one percent patients were classified as intermediate risk, and 59% as high risk according to Sanz's score. Thirty-three patients (85%) reached CR. Eleven of the 36 patients evaluable for DS (30.5%) developed this syndrome (severe in 7 cases, moderate in 4, and fatal in 3 cases) within a median of 12 days (range 3-23) of ATRA onset. Six of the 9 (66.6%) patients with BMI>or=30 developed DS vs. 5 of 27 (18.5%) with BMI<30 (p=0.012). Other predictors of DS in univariate analysis were: age>or=40 year (p=0.033), baseline WBC>or=20 x 10(9)/l (p=0.003), and creatinine>1.4 mg/dl (p=0.009). In multivariate analysis, BMI>or=30 remained an independent predictor of DS in addition to baseline WBC>or=20 x 10(9)/l.

摘要

体重指数（BMI）升高与 APL 发生率增加相关，但与 APL 分化综合征（DS）的发生无关。我们连续治疗了 39 例 ATRA 和伊达比星（根据 PETHEMA 方案）治疗的 APL 患者。中位年龄为 26 岁。41%的患者根据 Sanz 评分被分类为中危，59%为高危。33 例患者（85%）达到完全缓解。36 例可评估 DS 的患者中有 11 例（30.5%）在 ATRA 开始后中位 12 天（范围 3-23）内发生该综合征（7 例为重度，4 例为中度，3 例为致命性）。9 例 BMI≥30 的患者中有 6 例（66.6%）发生 DS，而 27 例 BMI<30 的患者中有 5 例（18.5%）发生 DS（p=0.012）。单因素分析中，DS 的其他预测因素包括：年龄≥40 岁（p=0.033）、基线白细胞计数（WBC）≥20×10(9)/l（p=0.003）和肌酐>1.4mg/dl（p=0.009）。多因素分析中，除了基线 WBC≥20×10(9)/l 外，BMI≥30 也是 DS 的独立预测因素。