摘要
目的探讨平均红细胞体积(MCV)与治疗相关急性髓系白血病(t-AML)患者临床特点及预后的相关性。方法回顾性分析41例t-AML患者的临床和实验室资料,根据MCV中位数将其分为低MCV组(LMCV组)和高MCV组(HMCV组)。采用Spearman秩相关分析,采用Kaplan-Meier法绘制生存曲线,组间比较采用Log-rank检验,多因素分析采用Cox比例风险回归模型。结果G-CSF治疗史与t-AML患者MCV成正相关(r=0.325,P<0.05)。与HMCV组相比,LMCV组患者外周血红细胞计数(RBC)和血红蛋白浓度(HGB)及PML-RARa融合基因阳性率更高(P<0.05),而淋系抗原CD7和CD56的表达率更低(P<0.05)。LMCV组患者治疗效果、OS和RFS均优于HMCV组(P<0.05)。未达到CR是影响t-AML患者OS的独立危险因素(P=0.002),而MCV≥98.9 fl虽然是影响t-AML患者OS和RFS的不良因素(P<0.1),但不是独立危险因素(P>0.05)。结论MCV水平不同的t-AML患者有不同的临床特点,高MCV患者治疗效果和预后均较差。
Objective To analyze the correlation of mean corpuscular volume(MCV)with clinical features and the prognosis of patients with treatment-related acute myeloid leukemia(t-AML).Methods The clinical and laboratory data of 41 patients with t-AML were retrospectively analyzed.The patients were divided into LMCV and HMCV groups.Spearman’s rank correlation was used for correlation analysis,and a survival curve was drawn via Kaplan-Meier method.Log-rank test was used for comparison between groups,and Cox proportional risk regression model was used for multivariate analysis.Results The treatment history of G-CSF was positively correlated with the MCV of patients with t-AML(correlation coefficient r=0.325,P<0.05).The amount of RBC and HGB in the peripheral blood of patients and the percentage of PML-RARa positive in the LMCV group were significantly higher than those in the HMCV group,and the percentages of the expression levels of lymphoid antigen CD7 and CD56 were significantly lower than those in the HMCV group(P<0.05).The therapeutic effect,OS,and RFS of the LMCV group were better than those of the HMCV group(P<0.05).Failure to reach CR was an independent risk factor for OS of patients with t-AML(HR=0.053,P=0.002),and MCV≥98.9 fl was an adverse factor for OS and RFS of patients with t-AML(P<0.1)but not an independent risk factor(P>0.05).Conclusion Patients with t-AML with different levels of MCV have different clinical characteristics,and patients with high MCV have poor therapeutic effect and prognosis.
作者
吕晓娴
许青霞
LYU Xiaoxian;XU Qingxia(Department of Clinical Laboratory,The Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer Hospital,Zhengzhou Key Laboratory of Digestive Tumor Markers,Zhengzhou 450008,China)
出处
《肿瘤防治研究》
2025年第5期405-410,共6页
Cancer Research on Prevention and Treatment
关键词
平均红细胞体积
治疗相关急性髓系白血病
临床特点
预后
Mean red blood cell volume
Treatment-related acute myeloid leukemia
Clinical characteristics
Prognosis
作者简介
吕晓娴,女,本科,副主任技师,主要从事骨髓和血细胞形态学分析,ORCID:0009-0009-4481-3939;通信作者:许青霞,女,本科,主任技师,主要从事临床实验诊断研究,E-mail:xqx202401@163.com,ORCID:0000-0002-9578-6784。
