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单中心成人慢性髓系白血病慢性期临床特点和生存分析

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目的:探讨单中心成人慢性髓系白血病慢性期(CML-CP)的临床特点及预后.方法:回顾性分析上海市奉贤区中心医院血液科自2015年1月至2021年5月收集的41例成人CML-CP患者临床资料,比较<60岁和≥60岁组患者的临床特点和预后.结果:41例患者中男性27例(65.9%),女性14例(34.1%),中位年龄56(19-48)岁,其中<60岁22例(53.7%),≥60岁19例(46.3%).单因素分析结果显示,≥60岁组初诊时有合并症、Sokal积分中/高危、骨髓纤维化、乳酸脱氢酶水平≥1 000 U/L的患者比例较<60岁组显著增加(均P<0.05).性别、ELST积分、白细胞数、血小板数、外周血嗜碱性粒细胞比例、外周血嗜酸性粒细胞比例和骨髓原始细胞比例等在两组间的分布差异无统计学差异(P>0.05).≥60岁组中服用减低剂量伊马替尼的患者比例明显上升(P<0.001);<60岁患者采用酪氨酸激酶抑制剂(TKI)治疗后的分子生物学缓解比例高于≥60岁患者(P<0.001).TKI治疗的非血液学不良反应发生率在≥60岁患者中的比例明显增加(P<0.001).多因素分析未发现影响TKI疗效及预后的不良因素.结论:与<60岁成人CML-CP患者相比,≥60岁患者TKI治疗获益较少且不良反应增加.
Clinical Characteristics and Survival Analysis of Single Center Adult Chronic Myeloid Leukemia in Chronic Phase
Objective:To investigate the clinical characteristics and prognosis of single center adult chronic myeloid leukemia in chronic phase(CML-CP).Methods:Clinical data of 41 adult CML-CP patients in Department of Hematology,Shanghai Fengxian District Central Hospital from January 2015 to May 2021 were retrospectively analyzed.The clinical characteristics and prognosis of patients between<60 years group and ≥ 60 years group were compared.Results:The 41 patients included 27(65.9%)males and 14(34.1%)females.The median age of the patients was 56(19-84)years,with 22 cases(53.7%)<60 years and 19 cases(46.3%)≥60 years.Univariate analysis indicated that the proportions of patients with comorbidities,intermediate/high-risk Sokal score,myelofibrosis,and lactate dehydrogenase ≥1 000 U/L were significantly increased in ≥60 years group compared with<60 years group at initial diagnosis(all P<0.05).There were no statistical differences in the distribution of sex,ELST score,white blood cell count,platelet count,peripheral blood basophil percentage,peripheral blood eosinophil percentage and bone marrow primitive cell percentage between the two groups(P>0.05).The proportion of patients taking reduced-dose imatinib in≥60 years group significantly increased(P<0.001).Patients<60 years had a higher proportion of molecular biological remission after treatment of tyrosine kinase inhibitors(TKIs)than patients ≥ 60 years(P<0.001).The incidence of non-hematologic adverse reactions to TKI therapy significantly increased in patients ≥ 60 years(P<0.001).Multivariate analysis showed that no adverse factors affecting the efficacy and prognosis of TKI.Conclusion:Compared with adult CML-CP patients<60 years,patients ≥ 60 years gain fewer benefits from TKI treatment and increased adverse reactions.

chronic myeloid leukemiatyrosine kinase inhibitorclinical characteristicsefficacyadverse reactions

焦霞霞、张园园、潘静、宋蕾娜、林彩芹、时会贞、朱斌、王素丽、潘韶英、丁志勇、赵文理

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上海交通大学附属第六人民医院南院,上海 201400

慢性髓系白血病 酪氨酸激酶抑制剂 临床特征 疗效 不良反应

2024

中国实验血液学杂志
中国病理生理学会

中国实验血液学杂志

CSTPCD北大核心
影响因子:0.988
ISSN:1009-2137
年,卷(期):2024.32(5)