Swirsky D M, de Bastos M, Parish S E, Rees J K, Hayhoe F G
Br J Haematol. 1986 Nov;64(3):435-53. doi: 10.1111/j.1365-2141.1986.tb02200.x.
Six hundred and nineteen patients with de novo acute myeloid leukaemia, entered into the Medical Research Council's eighth trial of therapy have been studied. All patients were treated with the same remission induction regimen. Pretreatment variables comprising age, clinical status, haematological status and a detailed marrow cytology and cytochemistry score have been analysed. Poorer remission rates have been found in older patients, in those with lower Karnofsky scores and in patients with a platelet count of less than 25 X 10(9)/l. Leukaemias showing evidence of cytoplasmic maturation along the granulocyte and monocyte lines, as evidenced by granules, Auer rods, a high percentage of Sudan black positive blast cells and morphological and cytochemical abnormalities of neutrophils were associated with a higher remission rate. Marrow eosinophilia was a good prognostic feature. Nuclear features of immaturity, i.e. increasing numbers and prominence of nucleoli were associated with a low remission rate. Abnormalities of the erythroid series, notably Periodic acid-Schiff positivity which was present in 133 cases (22% of the total), was associated with a low remission rate. Patient age and pretreatment Karnofsky score were the most useful predictors of treatment outcome.
对参加医学研究委员会第八次治疗试验的619例初发急性髓系白血病患者进行了研究。所有患者均采用相同的缓解诱导方案进行治疗。对包括年龄、临床状态、血液学状态以及详细的骨髓细胞学和细胞化学评分在内的预处理变量进行了分析。研究发现，年龄较大、卡诺夫斯基评分较低以及血小板计数低于25×10⁹/L的患者缓解率较低。白血病沿粒细胞和单核细胞系显示出细胞质成熟的证据，如颗粒、奥氏小体、高比例的苏丹黑阳性原始细胞以及中性粒细胞的形态和细胞化学异常，这些与较高的缓解率相关。骨髓嗜酸性粒细胞增多是一个良好的预后特征。核不成熟特征，即核仁数量增加和突出，与低缓解率相关。红系异常，尤其是133例（占总数的22%）出现的过碘酸-希夫阳性，与低缓解率相关。患者年龄和预处理卡诺夫斯基评分是治疗结果最有用的预测指标。
