成人急性白血病178例临床特点及治疗效果探讨

目的 总结成人急性白血病临床特点及治疗经验。方法 收集1994年1月-2004年10月收治的178例成人急性白血病病历，进行回顾性分析。结果 成人急性白血病院内感染发生率为53．4％，早期病死率为11．8％，常规治疗完全缓解率（CR）为43．8％，5年生存率为15．7％，急性髓细胞白血病（肌）和急性淋巴细胞白血病（ALL）两种类型间患者的缓解情况及5年生存率均无显著性差异（P〉0．05），以早幼粒细胞白血病（M3）的治疗效果最好。结论 成人急性白血病临床表现不典型，感染发生率较高，常规化疗后总体预后不理想，提倡采用个体化治疗方案。

Study on Clinical Manifestation and Experience in Treatment of 178 Adult Acute Leukemias

Objective To summarize the clinical manifestations and experience of treatment in adult acute leukemias. Methods Hospital data of 178 adult patients with acute leukemias were retrospectively reviewed. Results Incidence of nosocomial infection was 53.4%.The early stage mortality was 11.8%.The complete remission rate(CR) was 43.8% with standard induction regimen.The 5-year long-term survival rate was 15.7%.No significant difference between the acute myeloid leukemia and the acute lymphocytic leukemia in their remission and 5-year long-term survival rate was found.Acute progranulocytic leukemia had the best prognosis. Conclusion The adult patients with acute leukemia exhibited atypical clinical manifestations.The incidence of nosocomial infection was exceedingly high,and prognosis was poor after standard induction regimen.Individualized therapeutic strategies are recommended.