摘要
目的探讨70岁以上老年急性髓性白血病临床及生物学特征、影响预后的因素及个体化治疗方案。方法对我院1994-2005年收治58例老年AML患者（≥70岁）回顾性分析了其临床及生物学特征、影响预后的因素及治疗方案的比较。结果亚标准剂量组（A组）33例．减量组（B组）9例，支持治疗组（C组）8例。A组与B组缓解率差异无统计学意义（P〉0．05），分别为39．4％．22．2％。生存期明显异常（P=0．01）．分别为167天和68天。C组生存期176天，与亚标准化疗组差异无统计学意义（P〉0．05），但化疗引起副反应明显减少，平均住院时间缩短（P〈0．05）。预后因素分析表明：生存状态，继发性，PBWBC〉10×10^9／L．骨髓原始细胞比率〉50％，染色体核型，免疫表型是预后的显著影响因素。结论70岁以上AML患者有特殊的临床和生物学特征，治疗应个体化，其预后与多种因素有关。
Objective To explore the clinical and biological features ,prognostic factors and individualized treatment regimen of acute myelogenous leukemia patients over 70 years old. Methods We retrospectively analyzed 58 acute myelogenous leukemia（AML） patients over 70 years old who were diagnosed from 1994 to 2005 in our hospital. Results There were 33 cases in group A,9 cases in group B and 8 cases in group C.The complete remission（CR） rate of group A had no remarkahle difference with group B, 39.4% and 22.2% respectively.The mean survival time of group A was much longer than group B,167 and 68 days respectively. The mean survival time of group C was 176 days .There was no significant difference with that of group A.But the side effects of chemotherapy and the duration of hospitalization is observably reduced.The analysis of prognostic factors showed that PS, secondary AML, count of peripheral WBC 〉 10 × 10^9/L, percentage of blasts in bone marrow, karyotype and immunological phenotype affected overall survival（OS） significantly. Conclusions AML in patients over 70 years present their own clinical or biological features. The therapy should be individualized and many factors affect its prognosis.
出处
《老年医学与保健》
CAS
2006年第1期23-26,共4页
Geriatrics & Health Care
关键词
老年人
白血病
粒细胞
急性
治疗
预后
Aged
Lenkemia, myeloeytie, acute
Therapy
Prognosis
作者简介
邵彬,男,1980年生．现为复旦大学内科学硕士研究生。主要从事恶性血液病的诊断和治疗，急性血液病感染的研究。
通讯作者：周柱
