Joseph A S, Cinkotai K I, Hunt L, Geary C G
Br J Cancer. 1982 Aug;46(2):160-6. doi: 10.1038/bjc.1982.179.
The natural history of 45 cases of smouldering leukaemia has been studied. Males and females were equally represented, with a median age of 60.5. The median survival of the whole group was only 20 months, but rare cases lived 10 years or longer. 38% developed acute leukaemia; the remainder usually died of the results of marrow failure. Although it was possible to divide these marrow dysplasias morphologically into 3 major subgroups (refractory anaemia with excess of myeloblasts, chronic myelomonocytic leukaemia and chronic erythraemic myelosis), several displayed transitional features. Many showed refractory macrocytosis at diagnosis. The survival of the 3 groups was similar, though patients with high monocyte counts tended to present with less anaemia and fared rather better than the others. Statistical analysis suggests that increasing age, severe anaemia, thrombocytopenia and hepatomegaly are associated with a poor prognosis. Chemotherapy, when attempted, was usually unsuccessful.
对45例冒烟型白血病的自然病史进行了研究。男女比例均等，中位年龄为60.5岁。整个组的中位生存期仅为20个月，但罕见病例存活了10年或更长时间。38%的患者发展为急性白血病；其余患者通常死于骨髓衰竭的后果。虽然可以将这些骨髓发育异常在形态学上分为3个主要亚组（伴有过多原粒细胞的难治性贫血、慢性粒单核细胞白血病和慢性红白血病），但有几种表现出过渡特征。许多患者在诊断时表现为难治性大细胞性贫血。这3组的生存期相似，不过单核细胞计数高的患者贫血程度往往较轻，预后比其他患者稍好。统计分析表明，年龄增加、严重贫血、血小板减少和肝肿大与预后不良有关。尝试进行化疗时，通常不成功。
