急性髓系白血病M5亚型临床分析

目的探讨急性髓系白血病M5亚型(AML-M5)的临床特点,以提高对M5亚型的认识.方法回顾性分析1995年1月～2002年10月38例初发AML-M5的临床资料.结果与M2亚型相比,M5亚型的发病年龄大10岁左右,发病时肝、脾、淋巴结肿大及牙龈肿胀较多;高白细胞性急性白血病(HAL)发生率为47.4%,早期病死率是26.3%(明显高于M2亚型的14.7%和5.9%);完全缓解率61.1%,但短期内复发死亡率高,3年无病生存率仅7.7%(明显低于M2亚型的26.3%).结论M5亚型发病年龄大,HAL发生率高,髓外浸润严重,治疗难度大,预后恶劣.

Clinical analysis of M5 subtype of acute myeloid leukemia

Objective: To enhance the understanding of the clinical characteristics of M5. Methods: The clinical data of 38 patients with primary AML-M5 from January, 1995 to October, 2002 was analyzed with systemic retrospective methods. Results: The suffering age of M5, subtype was ten-year older than that of M2 subtype. Hepatomegaly, splenomegaly, lymphadenopathy, gingival swelling and hyperleukocyric acute leukemia (HAL) were more frequent in M5 subtype. The early mortality rate significantly increased in M5 subtype (26.3%) compared with M2 subtype (5.9%). Complete remission rate of M5 subtype was 61.1%, recurrence cases were more in short-period. 3-year free disease survival rate in M5 subtype was 7.7%, which was lower than that of M2 subtype (26.3%). Conclusion: This specific subtype of AML has significant extramedullary infiltration, higher early mortality, more refractory treatment and poorer prognosis.