摘要
目的探讨老年急性髓系白血病(AML)患者减低剂量化疗的临床疗效及预后影响因素。方法将40例老年AML患者按照数字表法随机分为两组,分别采用减低剂量方案(减低剂量组)、标准剂量方案(标准化疗组),各20例。比较两组的总有效率(ORR)、中位总生存(OS)期,采用多因素COX模型分析预后影响因素。结果减低剂量组和标准化疗组的ORR分别为55.0%、65.0%(P>0.05);减低剂量组中位OS期为8.0个月(95%CI:6.5～9.5),标准化疗组中位OS期为9.1个月(95%CI:8.2～9.9,P>0.05);多因素COX模型分析,结果显示,年龄、PS评分、初治时WBC计数及MRD-WT1表达阳性是影响老年AML患者预后的独立危险因素(P<0.05)。结论减低剂量化疗方案治疗老年AML患者的疗效和OS期与标准化疗方案相当,年龄、PS评分、初治时WBC计数及MRD-WT1表达阳性是影响其预后的独立危险因素。
Objective To compare clinical effect and influence factors of prognosis of reducing dose chemotherapy regimen in elderly patients with acute myeloid leukemia(AML).Methods Forty cases of elderly AML patients were randomly divided into two groups according to random number table.Low-dose group(n=20)was given reducing dose chemotherapy,and standard chemotherapy group(n=40)was given standard dose chemotherapy.The overall response rate(ORR),overall survival(OS)were observed.The influence factors for prognosis of elderly patients with AML were analyzed using multivariate COX model.Results There was no significant difference in the ORR between low-dose group(55.0%)and standard chemotherapy group(65.0%)(P>0.05).The median OS in low-dose group and standard chemotherapy group was 8.0 months(95%CI:6.5-9.5)and 9.1 months(95%CI:8.2-9.9),it was not statistically different(P>0.05).Multivariate COX model analysis showed that age,PS score,WBC count at initial treatment and positive expression of MRD-WT1were the risk factors for the prognosis of elderly patients with AML(P<0.05).Conclusion Reducing dose chemotherapy regimen in the treatment of elderly AML has similar effective rate and OS,and age,PS score,WBC count at initial treatment and positive expression of MRD-WT1 are the risk factors for the prognosis of elderly patients with AML.
作者
朱斌
丁志勇
赵文理
潘韶英
王素丽
刘娟娟
Zhu Bin;Ding Zhiyong;Zhao Wenli(South Hospital,Sixth People′s Hospital,Shanghai Health Medical College,Shanghai 201499,China)
出处
《医学研究杂志》
2019年第1期134-138,共5页
Journal of Medical Research
基金
上海健康医学院基金资助项目(HMSF-16-22-020)
关键词
老年
急性髓系白血病
减低剂量
预后
影响因素
Elderly
Acute myeloid leukemia
Reducing dose
Prognosis
Influence factors
