Gomez G A, Sokal J E, Walsh D
Cancer. 1981 May 15;47(10):2470-7. doi: 10.1002/1097-0142(19810515)47:10<2470::aid-cncr2820471026>3.0.co;2-0.
Clinical and laboratory findings at the time of diagnosis were correlated with the survival of 242 patients with chronic myelocytic leukemia. Twelve patients with the blastic stage of the disease (blasts greater than or equal to 29%) had a median survival of eight months. Of the nonblastic patients, 28 without the Philadelphia chromosome had a relatively constant mortality averaging 43% per year and a median survival of 13 months, markedly worse than the Ph1-positive group (mortality, 6% in the first year, 17% in the second year, and the 25% per year, with a median survival of 43 months; P less than 0.001). In the latter group of 202 patients, features reflecting the "quantity" of leukemia (leukocyte count, marrow cellularity, and M:E serum B12, different degrees of splenomegaly, presence or absence of symptoms) had weaker or short-term correlations with mortality, while "qualitative" abnormalities (e.g., increased percentage of circulating blast, extramedullary leukemic tumors, major abnormalities of erythropoiesis or platelet production, marked basophilia or eosinophilia) had strong and persistent correlations with mortality. Chromosome abnormalities in addition to the Ph appeared to have a delayed though significant effect on survival. Serum alkaline phosphatase and SGOT levels did not correlate significantly with survival, but major elevations of serum LDH were associated with increased mortality throughout the course of the disease.
对242例慢性粒细胞白血病患者诊断时的临床和实验室检查结果与生存率进行了相关性分析。12例处于疾病原始细胞阶段（原始细胞大于或等于29%）的患者中位生存期为8个月。在非原始细胞患者中，28例无费城染色体的患者死亡率相对稳定，平均每年43%，中位生存期为13个月，明显差于Ph1阳性组（第一年死亡率为6%，第二年为17%，随后每年为25%，中位生存期为43个月；P<0.001）。在这组202例患者中，反映白血病“数量”的特征（白细胞计数、骨髓细胞增多、M:E、血清B12、不同程度的脾肿大、有无症状）与死亡率的相关性较弱或为短期相关性，而“质量”异常（如循环原始细胞百分比增加、髓外白血病肿瘤、红细胞生成或血小板生成的主要异常、明显的嗜碱性粒细胞增多或嗜酸性粒细胞增多）与死亡率有强烈且持续的相关性。除Ph外的染色体异常似乎对生存有延迟但显著的影响。血清碱性磷酸酶和SGOT水平与生存率无显著相关性，但血清LDH的大幅升高与疾病全过程的死亡率增加相关。
