首页|亚砷酸诱导的老年急性早幼粒细胞白血病早期死亡分析

亚砷酸诱导的老年急性早幼粒细胞白血病早期死亡分析

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目的 分析经单药亚砷酸(arsenic trioxide,ATO)诱导治疗的老年(年龄≥60岁)初发急性早幼粒细胞白血病(acute promyelocytic leukemia,APL)的早期死亡(early death,ED)发生情况及预测因素.方法 收集连续收治的71例老年APL患者和456例年轻APL患者的临床资料.选取临床上可以快速获取的10个临床及实验室检测参数,采用x2检验及Logistic回归模型进行统计学分析.结果 老年患者的ED率(22.5%,16/71)高于年轻患者(15.1%,69/456),但差异无统计学意义(P=0.115).老年感染相关ED(8.5%)和血栓相关ED(2.3%)的发生率均显著高于年轻患者(分别为2.0%和0.3%),差异有统计学意义(P<0.01).男性和白细胞计数>10×109/L是两组患者ED的共同独立风险因素,低白蛋白血症(P<0.001)和血清纤维蛋白原<1g/L(P=0.001)还是年轻患者ED的独立风险因素.结论 单药ATO诱导治疗的老年APL患者的入院临床特征、ED发生情况及风险因素与年轻患者明显不同.因此,有必要对APL患者的ED情况进行年龄分层研究.
Analysis of Early Death in Elderly Patients with Acute Promyelocytic Leukemia Treated with Arsenic Trioxide Induction
Objective To analyze the occurrence and predictive factors of early death(ED)in elderly(≥60 years old)patients with newly diagnosed acute promyelocytic leukemia(APL)induced by single-agent arsenic trioxide(ATO).Methods The clinical da-ta of 71 consecutive elderly APL patients and 456 consecutive young APL patients were collected.Ten clinical and laboratory parameters,which could be obtained rapidly by clinicians were selected.Chi-square test and Logistic regression analysis were used for statistical a-nalysis.Results The ED rate in elderly patients(22.5%,16/71)was higher than that in young patients(15.1%,69/456),but the difference was not statistically significant(P=0.115).The incidence of infection-related ED(8.5%)and thrombosis-related ED(2.3%)in elderly patients was significantly higher than that in young patients(2.0%and 0.3%,respectively),and the difference was statistically significant(P<0.01).Peripheral white blood cell count>10 × 109/L and male were independent risk factors for ED in both the elderly and young patients.And hypoalbuminemia(P<0.001)and plasma fibrinogen<1g/L(P=0.001)were still independent risk factors for ED only in young patients.Conclusion When induced by single-agent ATO,the elderly APL patients were significantly different from the young patients in terms of clinical features,incidence and risk factors of ED.Therefore age-stratified study on ED in APL is necessary.

Arsenic trioxideAcute promyelocytic leukemiaElderlyEarly deathRisk factors

赵宇、胡天铭、金波、李慧波、张迎媚

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150001 哈尔滨医科大学附属第一医院实验诊断教研室

150001 哈尔滨医科大学附属第一医院血液科

510220 南方医科大学珠江医院血液科

150001 哈尔滨医科大学附属第一医院中心实验室、肝脾外科教育部重点实验室

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亚砷酸 急性早幼粒细胞白血病 老年 早期死亡 风险因素

国家自然科学基金青年科学基金

81903966

2024

医学研究杂志
中国医学科学院

医学研究杂志

CSTPCD
影响因子:0.702
ISSN:1673-548X
年,卷(期):2024.53(5)