难治性/复发性急性髓性白血病患者的临床特征及预后分析——来自本中心的结果

Baolin Chen, Xiaoyu Li, Fei Wang, Yixin Zhou
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引用次数: 1

摘要

目的:分析我中心难治性/复发性急性髓性白血病(AML)患者的临床特点及生存情况,了解近年来这些患者的生存是否有改善的趋势,并寻找与患者生存相关的预后因素。方法:对45例难治性/复发性AML患者进行回顾性分析。临床数据,包括复发前后的性别、年龄、AML的FAB分类、表现状态(PS)、细胞遗传学和分子异常、完全缓解(CR)持续时间、治疗选择(是否接受造血细胞移植)。采用Kaplan-Meier法和Log-rank检验确定上述因素对患者生存的影响。结果:45例难治性/复发性AML患者的平均生存时间为(36.25±8.40)个月,中位随访时间为(9±2.58)个月。1年和2年总生存率(OS)分别为(40.6±7.5)%和(23.7±7.0)%。单因素分析结果显示,年龄(p<0.05)和复发后接受造血干细胞移植(HSCT) (p<0.01)与这些患者的OS显著相关。结论:年龄和复发后是否接受移植是影响本中心难治性/复发性AML患者生存的关键因素。HSCT仍然是难治性/复发性AML患者的有效救助性治疗。我们的研究结果强调了这些患者的不同结果,并为复发后及时进行HSCT的重要性提供了证据,这有利于临床医生在未来做出临床决策。
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Analysis of Clinical Features and Prognosis in Patients with Refractory/Relapsed Acute Myeloid Leukemia- Results from Our Center
Objective: To analyse the clinical features and survival of patients with refractory/relapsed acute myeloid leukemia (AML) in our center, thus, to find out whether there is a trend of improvement in the survival of these patients in the past years and to search for prognostic factors which are associated with patients’ survival. Method: A total of 45 patients with refractory/relapsed AML were retrospectively reviewed. Clinical data, including gender, age, FAB classification of AML, performance status (PS), cytogenetic and molecular abnormities, complete remission (CR) duration, choices of treatment (whether to undergo hematopoietic stem cell transplantation) before and after relapse. The Kaplan-Meier method and the Log-rank test were conducted to determine the influence of those above factors on the patients’ survival. Results: The mean survival time of the 45 patients with refractory/relapsed AML was (36.25±8.40) months and the median follow up was (9±2.58) months. The one-year and two-years overall survival (OS) rate was (40.6±7.5) % and (23.7±7.0) %, respectively. Univariate analysis results demonstrated that age (p<0.05) and undergoing hematopoietic stem cell transplantation (HSCT) after relapse (p<0.01) were significantly related to OS in these patients. Conclusion: Age and whether to undergo HSCT after relapse are the key factors for the survival of patients with refractory/relapsed AML in our center. HSCT is still an effective salvage therapy for patients with refractory/relapsed AML. Our findings highlight the divergent outcomes of these patients and provide evidence to support the importance of timely HSCT after relapse, which is beneficial for clinicians to make clinical decisions in the future.
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