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目的探讨老年急性髓系白血病(AML)诱导缓解化疗的疗效和预后。方法收集76例年龄≥60岁AML患者[非急性早幼粒细胞白血病(APL)]的临床资料,对患者的预后因素进行分析,同时比较强化疗(n=39)及姑息治疗(n=37)的临床疗效。结果行强化疗和行姑息治疗患者的中位生存时间分别为18个月和7个月,差异有统计学意义(P=0.031)。单因素分析显示,年龄、核型和治疗方案的不同均是影响预后的因素,而骨髓原始细胞比例对预后无影响。多因素分析显示只有未接受化疗、高危核型是独立的预后不良因素。但高危核型的患者,行强化疗与姑息治疗中位生存时间差异无统计学意义(P=0.130)。结论强化疗可以改善老年AML患者的预后,延长中位生存期,但对于高危核型的患者,使用强化疗未得到更好的获益。
Objective To investigate the curative effect and prognosis of senile acute myeloid leukemia (AML) induced remission chemotherapy. Methods A total of 76 patients with AML (non-acute promyelocytic leukemia) [AML] were collected and their prognostic factors were analyzed. In addition, intensive chemotherapy (n = 39) and palliative treatment (n = 37) ) Clinical efficacy. Results The median survival time of intensive chemotherapy and palliative treatment were 18 months and 7 months, respectively, with significant difference (P = 0.031). Univariate analysis showed that the differences in age, karyotype and treatment regimen were the factors affecting the prognosis, while the proportion of bone marrow blast cells had no effect on the prognosis. Multivariate analysis showed that high-risk karyotype was an independent predictor of adverse prognosis only if chemotherapy was not performed. However, in patients with high-risk karyotypes, there was no significant difference in the median survival time between intensive chemotherapy and palliative treatment (P = 0.130). Conclusions Intensive chemotherapy can improve the prognosis of elderly AML patients and prolong the median survival time. However, intensive chemotherapy is not benefited for patients with high-risk karyotype.