Cervantes F, Rozman C
Blood. 1982 Dec;60(6):1298-304.
The prognostic value of different clinical and laboratory findings at diagnosis of chronic myeloid leukemia (CML) was analyzed in a series of 121 cytogenetically studied patients. From the univariate and multivariate analysis of the whole series it was apparent that the minority of Ph1-negative patients (11.5%) could be considered as a poor prognosis group. The analysis was then restricted to the Ph1-positive patients. From a multivariate survival analysis (Cox's regression model) of the latter group the following poor prognosis factors emerged: splenomegaly, hepatomegaly, presence of erythroid precursors in peripheral blood, and bone marrow myeloblasts over 5%. From the contribution of each one of these factors to the regression model, a clinical staging of Ph1-positive CML was derived: stage I (low risk, 32% of patients), including patients with one or no factors; stage II (intermediate risk, 38%), including cases with two factors; and stage III (high risk, 30%), including patients with three or four factors. The difference in survival of the patients at different stages was highly significant (p less than 0.001).
在一组121例经细胞遗传学研究的慢性髓性白血病（CML）患者中，分析了诊断时不同临床和实验室检查结果的预后价值。从对整个系列的单变量和多变量分析中可以明显看出，少数Ph1阴性患者（11.5%）可被视为预后不良组。然后将分析局限于Ph1阳性患者。从对后一组的多变量生存分析（Cox回归模型）中得出了以下预后不良因素：脾肿大、肝肿大、外周血中存在红系前体细胞以及骨髓原始粒细胞超过5%。根据这些因素中每一个对回归模型的贡献，得出了Ph1阳性CML的临床分期：I期（低风险，32%的患者），包括有一个或没有因素的患者；II期（中度风险，38%），包括有两个因素的病例；III期（高风险，30%），包括有三个或四个因素的患者。不同分期患者的生存差异具有高度显著性（p小于0.001）。
