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目的:探讨影响骨髓增生异常综合征(MDS)转化为急性白血病的高危因素。方法:回顾性分析我院收治的101例MDS患者的转白时间、转白亚型、临床特征、实验室数据等临床资料。结果:101例MDS患者中,34.6%(35/101)转化为急性髓系白血病,中位转白时间7.5(0.5~53)个月,中位生存时间40.7(1~87)个月。单因素分析发现,染色体核型、骨髓原始细胞比例、血细胞减少系数、病态造血累及系数、WHO分型均影响MDS患者的转白率(均P<0.05)。多因素分析发现,染色体核型、病态造血系数、WHO分型是MDS向急性白血病转化的独立危险因素(均P<0.05)。转白组患者较未转白组患者的生存期明显缩短(11个月∶45个月)。结论:MDS是一类高风险向急性白血病转化的疾病,根据相关高危因素,对其进行预后评估,从而为个体化治疗提供临床依据,对延长患者转白时间及总生存时间具有重要意义。
Objective: To investigate the risk factors that affect the conversion of myelodysplastic syndrome (MDS) to acute leukemia. Methods: A retrospective analysis of 101 cases of MDS patients admitted to our hospital turn white time, white subtype, clinical features, laboratory data and other clinical data. Results: Of the 101 patients with MDS, 34.6% (35/101) were converted to acute myeloid leukemia with a median transfer time of 7.5 (0.5-53 months) and a median survival time of 40.7 (1-87) months. Univariate analysis showed that chromosome karyotype, the proportion of primitive bone marrow cells, cytopenia coefficient, pathological hematopoietic coefficient, and WHO classification all affected the turn-over rate of MDS patients (all P <0.05). Multivariate analysis showed that karyotype, pathological hematopoietic coefficient and WHO classification were independent risk factors of MDS to acute leukemia (all P <0.05). Survival was significantly shorter in patients who transferred to the white group than in the non-transferred group (11 months: 45 months). Conclusion: MDS is a kind of high-risk disease of acute leukemia. According to the related risk factors, MDS is used to evaluate the prognosis. It provides a clinical basis for individualized treatment and is of great significance for prolonging the time of white-conversion and total survival of patients.