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目的 :探讨急性早幼粒细胞白血病 (APL)患者早期死亡原因。方法 :分析 12例早期死亡患者的临床资料。结果 :12例患者中 ,8例外周血白细胞大于 4 0× 10 9/L ,全部患者均检获t(15 ;17)及PML/RARα 基因 ,8例PML/RARα 基因为S型 ;9例死于DIC ,3例死亡与纤溶有关。结论 :具有高细胞负荷 ,FAB亚型为M3 b ,PML/RARα 基因为S型 ,未经ATRA诱导分化即开始联合化疗的APL易于早期死亡 ;并与DIC的发生和纤溶亢进有关。
Objective: To investigate the causes of early death in patients with acute promyelocytic leukemia (APL). Methods: Clinical data of 12 patients with early death were analyzed. Results: Among the 12 patients, the peripheral blood leukocytes in 8 cases were more than 40 × 10 9 / L, t (15; 17) and PML / RARα were all detected in all the patients, and the 8 PML / RARα genes were S; In DIC, 3 patients died of fibrinolysis. CONCLUSION: APB with high cell load, FAB subtype is M3 b, PML / RARα gene is S type, and APL which started chemotherapy without ATRA differentiation is prone to early death. It is also associated with the occurrence of DIC and fibrinolysis.