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目的探讨和分析非M_3型急性髓系白血病(AML)细胞遗传学及分子生物学特征以及预后影响因素。方法回归性分析99例非M_3型初治AML患者临床及实验室数据,探讨和分析患者性别、年龄、初诊时白细胞数、血小板数、有无贫血、乳酸脱氢酶水平、染色体核型以及融合基因等因素对AML患者无疾病进展生存时间(DFS)及总体生存时间(OS)的影响。结果患者中位发病年龄为44岁(1~84岁),中位随访时间为12.6月(0.33~59.47月),化疗后达完全缓解(CR)率为62.7%,复发率为44.1%,不同年龄段患者CR率有明显差异(P=0.035);单因素及多因素分析显示老年及染色体数目异常为AML患者OS的独立预后不良因素,t(8,21)/inv(16)系其独立预后良好因素。结论老年及染色体数目异常为非M_3型AML患者独立预后不良因素;t(8,21)/inv(16)是其独立预后良好因素。AML临床应结合年龄、细胞遗传学及分子生物学等预后因素进行预后评估,据此制定个体化治疗,对延长患者生存时间,提高生活质量,具有重要指导意义。
Objective To investigate and analyze the cytogenetics and molecular biology of non-M_3 acute myeloid leukemia (AML) and the influencing factors of prognosis. Methods The clinical and laboratory data of 99 non-M_3 naive AML patients were analyzed by regression analysis. The gender, age, number of white blood cells, platelet count, anemia, lactate dehydrogenase, chromosome karyotype and fusion Gene and other factors on disease-free survival time (DFS) and overall survival time (OS) in AML patients. Results The median age of onset was 44 years (ranging from 1 to 84 years). The median follow-up time was 12.6 months (range, 33 to 59.47 months). The rate of complete remission (CR) was 62.7% and the recurrence rate was 44.1% There was a significant difference (P = 0.035) in the CR rates among the age groups (P = 0.035). Univariate and multivariate analysis showed that the age and number of chromosome abnormalities were independent prognostic factors of OS in AML patients. T (8,21) / inv Good prognosis factors. Conclusion The age and number of chromosome abnormalities are independent prognostic factors for non-M_3 AML patients. T (8,21) / inv (16) is a good independent prognostic factor. AML clinical prognosis should be combined with prognosis factors such as age, cytogenetics and molecular biology. Therefore, it is of great significance to develop personalized therapy to prolong the survival time and improve the quality of life.