老年人急性白血病的临床特点

 目的　分析老年急性白血病（AL）的临床特点及治疗效果。方法　回顾性分析47例60岁以上老年AL患者的临床资料，并与同期住院的213例中青年AL患者进行比较。结果　老年急性髓细胞白血病（AML）∶急性淋巴细胞白血病（ALL）为4.22∶1。老年AL基础疾病的发病率（85.1 ％）、治疗相关死亡率（41.4 ％）均高于中青年组（P＜0.01）；骨髓增生低下发生率（10.6 ％）、既往骨髓增生异常综合征（MDS）病史率（10.6 ％）、早期死亡率（14.9 ％）均高于中青年组（P＜0.05）；骨髓原始+幼稚细胞为0.535±0.034，低于中青年组（P＜0.05）； CR率（24.1 ％）、1年生存率（29.8 ％）均低于中青年组（P＜0.01）。结论　老年AL有其临床特点，目前尚无早期诊断和治疗的有效策略，应引起重视。

Analysis of clinical features of elderly patients with acute leukemia

Objective　To discuss the clinical features and treatment outcome of elderly patients with AL. Methods　We reviewed the clinical data of 47 elderly patients with acute leukemia between January 2000 and January 2005,and compared with 213 younger adult AL patients in the same period. Results　The rate of elderly AML∶ALL is 4.22∶1. Underlying disease morbidity(85.1%) and death related with therapy(41.4 %) are prevalent in elderly AL than those in the younger adult AL patients（P< 0.01）. The low-growth bone marrow(10.6 %), MDS history(10.6 %) and early-death rate (14.9 %) are prevalent in elderly AL than those in the younger adult AL patients（P< 0.05）; The bone marrow blast cell (53.5±3.4 %) is lower in elderly AL than those in the younger adult AL patients（P< 0.05）. The CR rate (24.1 %) and one-year survival(29.8 %) were lower in elderly AL than those in the younger adult AL patients（P< 0.01）. Conclusion　At present; there are not satisfactory strategies to diagnose and treat efficientlyelderly AL patients in the early stage, so it should be paid more attention.