摘要
目的分析影响老年急性髓系白血病(AML)患者化疗效果的危险因素。方法选取商丘市第一人民医院2012年9月—2016年12月收治的76例老年AML患者纳入研究范围,按化疗效果分为有效及无效组,对比两组临床基本资料,并采用Logistic回归性分析影响老年AML患者化疗效果的危险因素。结果 76例患者中,第2个化疗周期结束后完全缓解41例(53.95%)、部分缓解25例(32.89%)、未缓解10例(13.16%),化疗有效率为53.95%(41/76)。其中有效组(41例)与化疗无效组(35例)在性别分布、原发性AML及继发性AML患者占比等资料上对比差异无统计学意义(P>0.05);但无效组中年龄≥70岁、高危核型、入院时ECOG评分≥3分、WBC≥100×109/L患者较有效组多,采用CAG方案治疗及接受巩固治疗患者显著较对照组少,对比差异有统计学意义(P<0.05),经多因素Logistic回归性分析,年龄≥70岁、高危核型、ECOG评分≥3分、WBC≥100×109/L均为影响老年AML患者化疗效果的独立危险因素。结论老年AML患者进行化疗治疗时,应综合年龄、核型、化疗前体力评估(ECOG评分)及WBC水平等因素充分考量,以制定个体化治疗方案,提升化疗效果。
Objective To analyze the risk factors influencing chemotherapy effects of elderly patients with acute myeloid leukemia（AML）. Methods A total of 76 elderly patients with AML treated in our hospital from Sept. 2012 to Dec.2016 were taken as the research objects,and they were divided into effective group and ineffective group according to their chemotherapy effects. The clinical basic data in the two groups were compared,and the risk factors influencing chemotherapy effects of elderly patients with AML were analyzed by Logistic regression analysis. Results After the second chemotherapy cycle,there were 41 cases（53. 95%） of complete remission,25 cases（32. 89%） of partial remission and 10 cases（13. 16%） of non remission,and the effective rate was 53. 95%（41/76）. There was no significant difference between the effective group（n = 41） and the ineffective group（n = 35） in gender distribution,primary AML and secondary AML（P〉0. 05）,but the patients with age ≥70 years old,high-risk karyotype,ECOG score at admission ≥3 points and WBC≥100 × 10^9/L in the ineffective group were more than those in the effective group,and the patients treated with the CAG regimen and consolidation therapy in the ineffective group were significantly less than those in the effective group,their differences were statistically significant（P〈0. 05）. The multivariate logistic regression analysis showed that age ≥70 years old,high risk karyotype,ECOG score ≥3 points and WBC≥100 × 10^9/L were independent risk factors influencing chemotherapy effects of elderly patients with AML. Conclusion Elderly patients with AML should be treated with chemotherapy according to their age,karyotype,preoperative physical evaluation（ECOG score） and WBC level,so as to develop an individualized treatment plan to improve their chemotherapy effects.
作者
胡青竹
田颖
王根杰
陈淑霞
HU Qing- zhu;TIAN Ying;WANG Gen- jie;CHEN Shu- xia(The First People＇s Hospital of Shangqia, Shangqiu, Henan 476100, China)
出处
《医药论坛杂志》
2018年第2期75-77,共3页
Journal of Medical Forum
