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急性髓系白血病患者接受标准3+7诱导治疗后完全缓解的频率。

Frequency of complete remission after standard 3+7 induction therapy in patients with acute myeloid leukemia.

作者信息

Shireen Iram, Komal Sumra, Ansari Abida Mateen, Meraj Lubna

机构信息

Iram Shireen, MBBS, FCPS. Post-Graduate Trainee, Medical Oncology, Jinnah Hospital, Lahore, Pakistan.

Sumra Komal, Pharm-D, M.Phil. Researcher, Department of Pharmacology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, 450001, China.

出版信息

Pak J Med Sci. 2022 May-Jun;38(5):1138-1142. doi: 10.12669/pjms.38.5.5249.

Abstract

OBJECTIVES

To find the frequency of complete remission rate after standard 3+7 induction therapy in patients with Acute Myeloid Leukemia (AML) among different clinicopathological groups.

METHODS

Non-probability purposive sampling technique was used to collect data from July 2016 to Jan 2017, conducted at Department of Oncology, Jinnah Hospital Lahore. Sample size of 50 cases was calculated with 95% confidence level, 14% margin of error and taking expected percentage of complete remission (CR) 57% in AML patients after 3+7 induction therapy.

RESULTS

Out of 46 patients, majority had AML-M2. AML- Not Otherwise Specified (NOS) disease. Most common pathological presentation was Total Leucocyte Count (TLC) of <50,000/mm (60%) as compared to patients with hyperleukocytosis i.e., TLC >50,000/mm (40%). Twenty-two percent had low Lactate Dehydrogenase (LDH) level involvement and 78% had high LDH level involvement. As compared to target of 57 %, complete response was observed in 54% patients, (p<0.02) with better results in younger age group, male patients with low LDH and TLC level.

CONCLUSION

It was concluded that 3+7 induction chemotherapy has 54% CR rates in patients with AML. Whereas, in AML-M5, AML-M6, AML-NOS patients especially, with high LDH and TLC and patients with advanced age, CR rate is low and needs more aggressive treatment.

摘要

目的

在不同临床病理组的急性髓系白血病(AML)患者中,寻找标准3+7诱导治疗后的完全缓解率。

方法

采用非概率立意抽样技术,于2016年7月至2017年1月在拉合尔真纳医院肿瘤科收集数据。计算得出样本量为50例,置信水平为95%,误差幅度为14%,并采用AML患者3+7诱导治疗后预期完全缓解(CR)百分比为57%。

结果

46例患者中,大多数为AML-M2。AML-未另行指定(NOS)疾病。最常见的病理表现是白细胞总数(TLC)<50,000/mm(60%),而白细胞增多症患者即TLC>50,000/mm(40%)。22%的患者乳酸脱氢酶(LDH)水平低,78%的患者LDH水平高。与57%的目标相比,54%的患者观察到完全缓解,(p<0.02),在年轻年龄组、LDH和TLC水平低的男性患者中结果更好。

结论

得出结论,3+7诱导化疗在AML患者中的CR率为54%。然而,在AML-M5、AML-M6、AML-NOS患者中,尤其是LDH和TLC高的患者以及老年患者,CR率低,需要更积极的治疗。

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本文引用的文献

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South Asian J Cancer. 2016 Jul-Sep;5(3):155-60. doi: 10.4103/2278-330X.187591.
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N Engl J Med. 2015 Sep 17;373(12):1136-52. doi: 10.1056/NEJMra1406184.
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Acute Myelogenous Leukemia and its Microenvironment: A Molecular Conversation.急性髓系白血病及其微环境:分子对话
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