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目的:探讨急性红白血病的生物学特点并对预后进行评价。方法:回顾分析2001-07—2011-07的64例急性红白血病患者,针对其形态学、免疫学、细胞遗传学和分子生物学(MICM)特征及生存期进行分析。采用病例对照方法,分为原发组和骨髓增生异常综合征(MDS)转化组,针对2组患者化疗和异基因造血干细胞移植(Allo-HSCT)治疗的疗效和生存预后分析。结果:原发组缓解率为62%(24/39),MDS转化组缓解率为47%(8/17),2者间差异无统计学意义(P>0.05)。染色体核型异常组和正常组的缓解率分别为41%(10/24)和69%(22/32),2者间差异有统计学意义(P<0.01)。MDS转化组17例,化疗与移植1年总生存率(OS)分别为25.0%和88.9%,差异有统计学意义(P<0.01)。染色体核型异常组24例,化疗与移植组1年OS分别为25.0%和85.6%,差异有统计学意义(P<0.01)。结论:64例患者中常规化疗疗效差、生存期短、预后差,Allo-HSCT显著延长生存期,改善预后,染色体核型异常患者诊断后宜早期行Allo-HSCT。
Objective: To investigate the biological characteristics of acute erythroleukemia and evaluate the prognosis. METHODS: Sixty-four patients with acute erythroleukemia from July 2001 to July 2011 were retrospectively analyzed for their morphological, immunological, cytogenetical and molecular biological (MICM) characteristics and survival. The case-control method was divided into primary group and MDS transformation group, and the curative effect and survival prognosis of chemotherapy and allogeneic hematopoietic stem cell transplantation (Allo-HSCT) in two groups were analyzed. Results: The remission rate was 62% (24/39) in the primary group and 47% (8/17) in the MDS conversion group. There was no significant difference between the two groups (P> 0.05). The rates of response to chromosomal aberrations and normal controls were 41% (10/24) and 69% (22/32), respectively. There was significant difference between the two groups (P <0.01). Seventeen patients with MDS had a one-year overall survival of 25.0% and 88.9%, respectively, with a statistically significant difference (P <0.01). Chromosome karyotype abnormalities in 24 cases, chemotherapy and transplantation group 1 year OS were 25.0% and 85.6%, the difference was statistically significant (P <0.01). CONCLUSION: Allo-HSCT significantly prolongs survival and improves prognosis in 64 patients with conventional chemotherapy, with short survival and poor prognosis. Allo-HSCT should be performed early after diagnosis in patients with chromosomal abnormalities.