The prognostic value of the peripheral blood cell counts changes during induction chemotherapy in Chinese patients with adult acute myeloid leukemia.
The prognostic value of the peripheral blood cell counts changes during induction chemotherapy in Chinese patients with adult acute myeloid leukemia.
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中国成人急性髓系白血病诱导化疗期间外周血细胞计数变化的预后价值
DOI：
10.1097/md.0000000000024614
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发表时间：
2021-02-26
期刊：
影响因子：
1.6
通讯作者：
Wang SY
中科院分区：
文献类型：
--
作者：
Huang YM;Wang YN;Zheng Y;Pan LL;Li Y;Li JG;Wang SY
目的探讨急性髓系白血病（AML）诱导化疗期间不同时间点外周血细胞计数的变化对预后的价值。我们回顾性分析了2011年1月至2014年12月福建医科大学附属协和医院收治的237例初治AML患者的临床和实验室资料。1.当原始细胞首次从循环外周血中去除时，称为外周血原始细胞清除（PBBC）。根据PBBC分为两组。统计学分析表明，诱导化疗的第5天是一个更好的截断PBBC。PBBC≤5天定义为早期胚细胞清除，而PBBC >6天定义为延迟胚细胞清除。 两组在完全缓解（CR）率（P = 0.002）、无复发生存（RFS）（P = 0.026）和总生存（OS）（P = 0.001）方面存在显著差异。 2.多因素分析提示PBBC是AML患者CR、RFS和OS的独立预后因素。受试者工作特征（ROC）曲线分析显示，诱导化疗第5天白色细胞计数<1.25 × 109/L的患者CR率显著高于白色细胞计数> 1.25 × 109/L的患者（P <.001），而RFS和OS差异无显著性（P>.05）。 诱导化疗开始后AML外周血原始细胞的动态变化，尤其是达到PBBC的时间长度，对AML患者的CR率、RFS和OS具有重要的预后价值。该方法简便、可行，可用于急性髓细胞白血病的疗效评价。
Abstract To investigate the prognostic value of the circulating peripheral blood cell counts changes in acute myeloid leukemia (AML) at different time points during induction chemotherapy. We retrospectively analyzed the clinical and laboratory data of 237 newly diagnosed AML patients admitted to Fujian Medical University Union Hospital from January 2011 to December 2014. 1. When primitive cells were first removed from the circulating peripheral blood, it was called peripheral blood blast clearance (PBBC). These patients were divided into two groups, according to PBBC. Statistical analysis showed that the day 5 of induction chemotherapy was a better cut-off for PBBC. PBBC≤5 days is defined as early-blast-clearance, while PBBC >6 days is delayed-blast-clearance. There was significant difference between the two groups on complete remission (CR) rate (P = .002), recurrence-free survival (RFS) (P = .026) and overall survival (OS) (P = .001). 2. Multivariate analysis suggested PBBC is an independent prognostic factor for CR, RFS, and OS in AML. Receiver operating characteristic(ROC) curve analysis showed the CR rate of patients with white blood cell count less than 1.25 × 109/L was significantly higher than that of patients with white blood cell count more than 1.25 × 10 9/L (P < .001) at day 5 of induction chemotherapy, but the RFS and OS was no significantly different (P > .05). The dynamics of peripheral blood blast in AML after initiation of induction chemotherapy, especially the time length to achieve PBBC, has important prognostic value for CR rate, RFS, and OS in AML patients. It is a simple and feasible method to evaluate the efficacy of AML.