Molica S, Alberti A
Divisione di Ematologia, Ospedale Regionale A. Pugliese, Catanzaro, Italy.
Cancer. 1987 Dec 1;60(11):2712-6. doi: 10.1002/1097-0142(19871201)60:11<2712::aid-cncr2820601122>3.0.co;2-1.
The prognostic value of lymphocyte doubling time (LDT), expressed in months and obtained by means of a linear regression, has been studied in 99 previously untreated chronic lymphocytic leukemia (CLL) patients. LDT is defined as the period of time needed for lymphocytes to double in number the amount found at diagnosis. When the analysis was extended to the whole population, it showed clear differences in the life expectancy of patients with LDT of less than or equal to 12 months (median survival, 36 months; relative death rate [O/E]1.57) compared with those with LDT of more than 12 months (median survival not yet reached; O/E, 0.37) (P less than 0.001). The significance of LDT remained even after adjustments were made for age, sex, lymphocyte count, anemia, and thrombocytopenia. The lack of statistical significance after adjustment for Binet's clinical stage corresponds to the fact that clinical stages are not distributed homogeneously, high LDT being more frequently associated with earlier stages and low LDT with more advanced forms of the disease (P less than 0.001). In this study LDT was a useful parameter in predicting disease progression. Patients in Stages A and B and with rapidly increasing lymphocytes counts became worse more frequently (33.3% and 29.1%, respectively, at 12 months after diagnosis) than those with a slow increase (no change in clinical stage at 12 months). It is concluded that since LDT appears to predict the progression of the disease, it is useful in the clinical management of CLL.
我们对99例未经治疗的慢性淋巴细胞白血病（CLL）患者进行了研究，通过线性回归计算得出以月为单位的淋巴细胞倍增时间（LDT）的预后价值。LDT定义为淋巴细胞数量增加一倍所需的时间，该数量是指诊断时发现的淋巴细胞数量。当将分析扩展至整个人群时，结果显示，LDT小于或等于12个月的患者（中位生存期为36个月；相对死亡率[O/E]为1.57）与LDT大于12个月的患者（中位生存期尚未达到；O/E为0.37）相比，预期寿命存在明显差异（P<0.001）。即使在对年龄、性别、淋巴细胞计数、贫血和血小板减少症进行校正后，LDT的意义依然存在。校正Binet临床分期后缺乏统计学意义，这与临床分期分布不均匀这一事实相符，即高LDT更常与早期阶段相关，而低LDT与疾病的更晚期形式相关（P<0.001）。在本研究中，LDT是预测疾病进展的一个有用参数。A期和B期且淋巴细胞计数快速增加的患者（诊断后12个月时分别为33.3%和29.1%）比淋巴细胞计数缓慢增加的患者（12个月时临床分期无变化）病情恶化更为频繁。研究得出结论，由于LDT似乎可以预测疾病进展，因此它在CLL的临床管理中很有用。
