Ph染色体阳性慢性粒细胞白血病患者多因素预后分析

目的 探讨影响Ph阳性慢性粒细胞白血病（CGL）患者生存期的因素。方法 对209例CGL患者的临床体征、血常规和骨髓象进行单因素预后分析，然后对有意义的单因素用COX回归模型进行多因素综合分析。结果 209例患者中位生存时间57个月（3－179个月），5年生存率48％。经COX回归多因素综合分析，外周血原始粒细胞、早幼粒细胞、出现有核红细胞、骨髓原始粒细胞（≥0．04）为影响生存期的4个主要因素。依评分指数公式分为低危、中危和高危组，中位生存时间分别为76．0，56．0和31．5个月（P＜0．01），5年生存率分别为70．42％、46．30％和18．18％（P＜0．01）。结论 提出适合我国CGL患者的预后评分指数公式。

Multivariate analysis of prognostic factors in Philadelphia chromosome-positive chronic granulocytic leukemia

OBJECTIVE: To investigate the prognostic factors of the patients with Philadelphia chromosome-positive chronic granulocytic leukemia (CGL). METHODS: Clinical and laboratory parameters of 209 CGL patients at diagnosis were analyzed in relation to survival. COX regression analysis were used to identify the statistically significant prognostic factors. RESULTS: The median survival time was 57 (3 - 179) months, and 5 year survival rate was 48%. From the COX regression model, the four main poor prognostic factors were as follows: percentage of bone marrow blasts (>or= 0.04), percentage of peripheral blood blasts and promyelocytes and presence of erythroid precursors in peripheral blood. According to the prognostic scores, three groups of CGL were identified. The low-risk group was with a median survival time of 76 months, the intermediate-risk group with 56 months, and the high-risk group with 31.5 months (P < 0.01). The 5 year survival rate was 70.42%, 46.30% and 18.18% (P < 0.01), respectively. CONCLUSIONS: A prognostic scoring system suitable for Chinese CGL patients was proposed.