116例成人急性非早幼细胞髓系白血病预后因素分析

目的探讨成人急性髓系白血病（非APL）预后相关因素。方法回顾性分析北大深圳医院血液内科116例初发AML患者临床特征：年龄、初发WBC水平、骨髓细胞免疫表型特征与预后关系。结果完全缓解（CR）率：总CR率70．7％（82／116），≥60岁组58．6％（17／29），显著低于〈60岁组74．7％（65／87）；初发wBC≥30×10^9／L组52．2％（25／48），显著低于〈30×10^9／L组83．8％（57／68）；CD34阳性组59．7％（40／67），低于CD34阴性组85．7％（42／49）；2年复发率：CD34阳性组76．0％（19／25），显著高于CD34阴性组14．3％（3／18）。多因素分析：≥60岁、初发wBc≥30×10^9／L是CR率的独立危险因素；CD34阳性是2年复发率的独立危险因素；CD34阳性是长期生存的独立危险因素。结论CD34阳性是复发率、长期生存的独立危险因素。

Prognostic factors analysis in 116 cases of adult acute non - APL myeloid leukemia

Objective ： To analyze the prognostic factors of adult acute non - APL myeloid leukemia. Methods ： 116 cases of initial AML in Peking University Shenzhen hospital in - patient department were retrospective analyzed. The clinical information for prognosis included： gender, age, WBC level at diagnosis and immunophenotyping. Result： CR rates： The overall rate was 70.7% （82/116）. The rate of ≥60 year old patients was 58.6% （17/ 29）, significantly lower than 〈 60 year old patients, 74.7% （65/87）. The rate of WBC at diagnosis 〉130 × 10^9/L patients was 52.2% （25/48）, significantly lower than 〈 30 × 10^9/L patients, 83.8% （57/68）. The rate of CD34 positive patients was 59.7% （40/67）, lower than CD34 negative patients, 85.7% （42/49）. Recurrent rates in 2 years： the rate of CD34 positive patients was 76.0% （ 19/25）, significantly higher than CD34 negative patients, 14.3% （3/18）. Multiple factor analysis ： ≥ 60 year old, WBC at diagnosis ≥ 30 × 10^9/L were independent risk factors of CR rate. CD34 positive was independent risk factor of recurrence. CD34 positive was independent risk factor of long - term survival. Conclusion ： CD34 positive was independent risk factor of recurrence and long - term survival.