摘要
目的:探讨初治成年急性髓系白血病(AML)患者诱导化疗完全缓解(CR)后血小板计数(Plt)恢复情况与微小残留病(MRD)及临床特征的相关性。方法:回顾性分析2016年1月至2021年12月靖江市人民医院收治的57例诱导化疗达CR的初治AML(非急性早幼粒细胞白血病)患者临床资料。根据Plt恢复程度分为Plt恢复过高组(Plt恢复至>350×10^(9)/L)和Plt恢复正常组[Plt恢复至(100~350)×10^(9)/L]。患者接受1个疗程标准方案或1~2个疗程去甲基化药物联合预激方案达CR后,采用多参数流式细胞术(MFC)分析患者MRD,比较两组之间MFC-MRD阴性率及临床特征的差异。结果:57例达CR患者中,Plt恢复过高31例(54.4%),Plt恢复正常26例(45.6%)。Plt恢复过高组MFC-MRD阴性率为67.7%(21/31),Plt恢复正常组为38.5%(10/26),差异有统计学意义(χ^(2)=4.89,P=0.027)。Plt恢复正常组和Plt恢复过高组不同性别、年龄、初诊时白细胞计数及Plt、化疗方案以及危险度分层的患者比例比较,差异均无统计学意义(均P>0.05)。结论:AML患者诱导化疗达CR后Plt恢复至较高水平与MRD转阴有一定相关性,对疗效判断具有一定价值。
Objective:To investigate the correlation of excessive platelet (Plt) recovery at the first time of achieving morphologic complete remission (CR) after induction chemotherapy with minimal residual disease (MRD) and the clinical features of acute myeloid leukemia (AML).Methods:The clinical data of newly-treated 57 AML patients (except for acute promyelocytic leukemia) who achieved CR after induction chemotherapy in Jinjiang People's Hospital from January 2016 to December 2021 were retrospectively analyzed. A total of 57 newly diagnosed adult AML patients were divided into excessive Plt recovery group (Plt recovery>350×10 9/L) and normal Plt recovery group [Plt recovery: (100-350)×10 9/L] according to the Plt recovery. Meanwhile, the MRD was analyzed by using multiparameter flow cytometry (MFC) in patients achieving CR after receiving 1 course of standard treatment regimen or 1-2 courses of demethylation drugs combined with pre-conditioning regimen. The clinical features and negative rate of MRD between the two groups were compared. Results:Among 57 CR patients, 31 (54.4%) patients had CR with excessive Plt recovery and MFC-MRD negative rate was 67.7% (21/31);26 (45.6%) had CR with normal Plt recovery and MFC-MRD negative rate was 38.5% (10/26);and the difference in the proportion of MRD negative patients between the both groups was statistically significant ( χ^(2) = 4.89, P = 0.027). There were no statistically differences in the proportions of patients with different gender, age, WBC at initial diagnosis, Plt, chemotherapy regimen and risk degree classification between the two groups (all P > 0.05). Conclusions:In AML patients, excessive Plt recovery at the first time of achieving morphologic CR after induction chemotherapy is associated with negative MRD, which has a certain value in the judgement of therapeutic effect.
作者
陈浩月
孙淼
刘春华
韩乔燕
李晓蕊
Chen Haoyue;Sun Miao;Liu Chunhua;Han Qiaoyan;Li Xiaorui(Departmentof Hematology,Jinjiang People'sHospital,Jinjiang214500,China)
出处
《白血病．淋巴瘤》
CAS
2022年第11期655-658,共4页
Journal of Leukemia & Lymphoma
关键词
白血病
髓样
急性
血小板计数
微小残留病
Leukemia
myeloid
acutePlatelet count
Minimal residual disease
