Rubio-Félix D, Franco E, Giraldo P, Gimeno J, Cuesta I, Giralt M
Hospital Miguel Servet, Servicio de Hematología y Hemoterapia, Zaragoza.
Sangre (Barc). 1994 Apr;39(2):117-20.
To evaluate the transfusion requirements (red cells and platelets) in 226 patients with myelodysplastic syndromes (MDS).
The number of patients under study was 226: 59 with refractory anaemia (RA), 49 with sideroblastic anaemia (RSA), 56 with refractory anaemia with excess of blast cells (RAEB), 48 with RAEB in transformation (RAEBT), and 14 with chronic myelomonocytic leukaemia (CMML). The period of the study was from January 1975 to December 1992. The mean age of the series was 67.4 years (ranging between 28 and 92) and the male/female ratio was 1.8. Transfusion frequency (TF) was defined as the time elapsed between two consecutive transfusions of two units of packed red cells. A platelet transfusion (PT) was comprised of 6 units of platelets or 1 unit obtained by thrombopheresis. The statistical analysis was performed with the chi 2 and Student's tests.
Anaemia was present in 96.9% of the patients, regardless of the cytologic classification. Haemorrhages appeared in 41.6% of the cases with maximal frequency in CMML (78.6%) and minimal in RSA (10.2%). TF: Transfusion was required by 90.2% of the patients (86% of the RA, 79.6% of the RSA, 48.4% of RAEB, 97.9% of the RAEB-T, and 100% of the CMML). The mean TF was 1.5 months (1.9 for RA, 1.7 for RSA, 1.3 for RAEB, 0.9 for RAEB-T, 2.2. for CMML). PT: Platelet support was needed by 38.1% of the patients (30.5% of RA, 8.1% of RSA, 48.2% of RAEB, 58.3% of RAEB-T and 64.3% of CMML). The mean number of PT per patient was 7.2 (5.2 for RA, 3.8 for RSA, 9.7 for RAEB, 10.2 for RAEB-T, 7.1 for CMML).
The differences appreciated in TF were significant for the good prognostic groups (RA + RSA) as compared with the poor-risk ones (AREB + AREB-T + CMML) (p < 0.01), although significance is lost when these groups were taken one by one. For PT, significant differences appeared when comparing RA + RSA with RAEB + RAEB-T + CMML (p < 0.001); when the groups were compared one by one, significant differences were found only for RA versus RSA (p < 0.01).
评估226例骨髓增生异常综合征（MDS）患者的输血需求（红细胞和血小板）。
研究对象为226例患者，其中难治性贫血（RA）59例、铁粒幼细胞贫血（RSA）49例、难治性贫血伴原始细胞增多（RAEB）56例、转化中的RAEB（RAEBT）48例、慢性粒-单核细胞白血病（CMML）14例。研究时段为1975年1月至1992年12月。该组患者的平均年龄为67.4岁（范围在28至92岁之间），男女比例为1.8。输血频率（TF）定义为两次连续输注两单位浓缩红细胞之间的时间间隔。一次血小板输注（PT）由6单位血小板或通过血小板单采获得的1单位血小板组成。采用卡方检验和学生检验进行统计分析。
无论细胞学分类如何，96.9%的患者存在贫血。41.6%的病例出现出血，其中CMML出血频率最高（78.6%），RSA最低（10.2%）。TF：90.2%的患者需要输血（RA患者中的86%、RSA患者中的79.6%、RAEB患者中的48.4%、RAEB-T患者中的97.9%、CMML患者中的100%）。平均TF为1.5个月（RA为1.9个月、RSA为1.7个月、RAEB为1.3个月、RAEB-T为0.9个月、CMML为2.2个月）。PT：38.1%的患者需要血小板支持（RA患者中的30.5%、RSA患者中的8.1%、RAEB患者中的48.2%、RAEB-T患者中的58.3%、CMML患者中的64.3%）。每位患者PT的平均次数为7.2次（RA为5.2次、RSA为3.8次、RAEB为9.7次、RAEB-T为10.2次、CMML为7.1次）。
与预后不良组（RAEB + RAEB-T + CMML）相比，预后良好组（RA + RSA）在TF方面的差异具有统计学意义（p < 0.01），不过当逐个比较这些组时，该意义消失。对于PT，比较RA + RSA与RAEB + RAEB-T + CMML时出现显著差异（p < 0.001）；当逐个比较这些组时，仅RA与RSA之间存在显著差异（p < 0.01）。
1）90.2%的MDS患者需要红细胞支持，而38.1%的病例需要血小板支持。2）细胞学预后不良组（RAEB、RAEB-T和CMML）总体上比预后良好组（RA + RSA）需要更多的输血支持。3）然而，仅RA在PT方面与RSA存在显著差异，其余组未见此类差异。4）RA在PT方面以及CMML在TF和PT方面均呈现不规则模式。
