摘要
目的分析急性单核细胞白血病(AML-M5)患者的临床特点与其预后的相关因素。方法回顾性分析97例AML-M5患者并随访1年,依据其临床结果(死亡或生存)分为预后良好组与预后不良组,收集所有患者的年龄、性别等资料,采用多因素Logistic回归分析模型分析影响AML-M5患者预后的相关因素。结果97例患者中,以发热为就诊原因的共51例(52.58%),其次为头晕乏力18例(18.56%)、牙龈肿痛及口腔溃疡14例(14.43%)等;骨髓增生程度分级以极度活跃为主,共47例(48.45%),其次为显著活跃20例(20.62%),活跃17例(17.53%),减低9例(9.28%),极度减低4例(4.12%)。随访1年,97例患者中生存80例(82.47%),死亡17例(17.53%);单因素分析显示:年龄、微小残留灶有无、功能状态评分(PS)、初治时白细胞计数与AML-M5患者预后有关(P<0.05)。多因素Logistic回归分析显示:年龄≥60岁、有微小残留灶、PS评分≥2分、初治时白细胞计数>50×10^(9)/L为AML-M5患者预后的独立影响因素(P<0.05)。结论AML-M5患者多数以发热就诊,而影响其预后的因素众多,如年龄≥60岁、有微小残留灶、PS评分≥2分、初治时白细胞计数>50×10^(9)/L等。因此,临床需对上述高危人群予以重视,并施以个体化的防治手段。
Objective To analyze the clinical characteristics and prognostic factors of acute monocytic leukemia(AML M5)patients.Methods A retrospective analysis was conducted on 97 AML M5 patients who were followed up for 1 year.They were divided into a good prognosis group and a poor prognosis group based on their clinical outcomes(death or survival).Data on age,gender,and other factors of all patients were collected,and a multivariate logistic regression analysis model was used to analyze the relevant factors affecting the prognosis of AML M5 patients.Results Among the 97 patients,a total of 51(52.58%)were diagnosed with fever,followed by 18(18.56%)with dizziness and fatigue,14(14.43%)with gingival swelling and pain,and oral ulcers;The degree of bone marrow hyperplasia was mainly classified as extremely active in 47 cases(48.45%),followed by significantly active in 20 cases(20.62%),active in 17 cases(17.53%),decreased in 9 cases(9.28%),and extremely reduced in 4 cases(4.12%).During a one-year follow-up,80 out of 97 patients survived(82.47%)and 17 died(17.53%);Univariate analysis showed that age,presence or absence of minimal residual lesions,functional state score(PS),and initial white blood cell count were associated with the prognosis of AML M5 patients(P<0.05).Multivariate logistic regression analysis showed that age≥60 years old,minimal residual lesions,PS score≥2 points,and white blood cell count>50×10^(9)/L at initial treatment is an independent prognostic factor for AML M5 patients(P<0.05).Conclusion Most AML M5 patients seek treatment with fever,and there are many factors that affect their prognosis,such as age≥60 years old,minimal residual lesions,PS score≥2 points,and white blood cell count>50 at initial treatment×10^(9)/L,etc.Therefore,clinical attention should be paid to the high-risk groups mentioned above and personalized prevention and treatment measures should be implemented.
作者
刘利红
米瑞华
马春霞
LIU Lihong;MI Ruihua;MA Chunxia(Zhengzhou University Affiliated Cancer Hospital,Zhengzhou,450000)
出处
《实用癌症杂志》
2024年第4期576-578,597,共4页
The Practical Journal of Cancer
