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目的探讨常用临床指标在急性淋巴细胞白血病(ALL)预后中的意义。方法收集101例成人急性淋巴细胞白血病资料,按照MRC UKALL XII/ECOG2993研究标准的危险度分级将其分为标危组(n=34)和高危组(n=67),分析其免疫表型、造血干细胞移植及细胞遗传学特征,比较不同危险度分级、免疫表型、造血干细胞移植以及细胞遗传学对预后的影响。结果标危组总生存率(OS)优于高危组,但差异无统计学意义(P>0.05),无病生存率(DFS)优于高危组且差异有统计学意义(P<0.05)。CD10阳性ALL的OS及DFS较阴性者好,不伴髓系抗原表达ALL的OS及DFS较伴髓系抗原表达的好,但差异均无统计学意义(P>0.05)。造血干细胞移植能够明显改善ALL患者OS及DFS(P<0.05),其中对标危组预后差异无统计学意义(P>0.05),对高危组预后差异有统计学意义(P<0.05)。结论目前常用的临床指标对于ALL的预后判断有重要价值,但尚存在一定局限性,ALL的预后指标需要进一步探索和完善。
Objective To investigate the clinical significance of common clinical indexes in the prognosis of acute lymphoblastic leukemia (ALL). Methods The data of 101 adult patients with acute lymphoblastic leukemia were collected and divided into standard risk group (n = 34) and high risk group (n = 67) according to the risk grade of MRC UKALL XII / ECOG2993 to analyze the immunophenotype, Hematopoietic stem cell transplantation and cytogenetic characteristics, the impact of different risk classification, immunophenotype, hematopoietic stem cell transplantation and cytogenetics on prognosis. Results The overall survival rate in the standard risk group was better than that in the high risk group, but the difference was not statistically significant (P> 0.05). The disease free survival (DFS) was superior to the high risk group (P <0.05). The OS and DFS of CD10-positive ALL were better than that of negative ones. The OS and DFS of non-myeloid antigen-expressing ALL were better than those of myeloid antigens, but the difference was not statistically significant (P> 0.05). The hematopoietic stem cell transplantation could significantly improve the OS and DFS in patients with ALL (P <0.05), but there was no significant difference in the prognosis of the standard risk group (P> 0.05). The prognosis of high risk group was statistically significant (P <0.05). Conclusion The commonly used clinical indicators have important value in the prognosis of ALL, but there are some limitations. The prognostic indicators of ALL need to be further explored and improved.