Prognostic impact of bone marrow erythropoietic precursor cells and myelofibrosis at diagnosis of Ph1+ chronic myelogenous leukaemia – a multicentre study on 495 patients
Prognostic impact of bone marrow erythropoietic precursor cells and myelofibrosis at diagnosis of Ph1+ chronic myelogenous leukaemia – a multicentre study on 495 patients
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骨髓红细胞生成前体细胞和骨髓纤维化对诊断 Ph1+ 慢性粒细胞白血病的预后影响——一项针对 495 名患者的多中心研究
DOI：
10.1046/j.1365-2141.2001.02555.x
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发表时间：
2001
影响因子：
6.5
通讯作者：
H. Schaefer
中科院分区：
文献类型：
--
作者：
H. Kvasnicka;J. Thiele;A. Schmitt;V. Diehl;R. Zankovich;N. Niederle;L. Leder;H. Schaefer
一项多中心临床病理研究对495例慢性期Ph1+慢性髓性白血病（CML）患者进行了研究，以确定在标准治疗方案下对生存有重大影响的骨髓特征。应用免疫组织化学和形态计量学技术鉴定骨髓中有核红细胞前体细胞，并定量测定亲银纤维密度。应用Sokal指数和最近提出的另一个CML评分未能区分三个明确定义的风险组。根据两项临床评分，纤维含量的边缘性增加（即正常密度的两倍）和髓质红细胞生成的相关减少被证明是生存的重要预测因素，即使在低风险分类的患者中也是如此。在最佳治疗策略方面，明显骨髓纤维化患者在干扰素或羟基脲治疗下的生存率无显著差异。多因素分析证实了组织学特征的预后价值。建立了基于三个变量（纤维密度、红细胞前体和脾脏大小）的风险模型，可以对风险概况进行明显的区分。总之，目前的数据提供了令人信服的证据，证明诊断时的骨髓特征对CML的预后有显著影响。在这种情况下，通常基于临床的多变量风险分类可以通过考虑独立于治疗方式的形态学变量来改进。
A multicentre clinicopathological study was performed on 495 patients with chronic‐phase Ph1+ chronic myelogenous leukaemia (CML) to determine bone marrow characteristics that exert a significant impact on survival under standard treatment regimens. Immunohistochemical and morphometric techniques were applied to identify nucleated erythroid precursor cells in the bone marrow and to quantify argyrophilic fibre density. Application of the Sokal index and another recently proposed CML score failed to distinguish three clearly defined risk groups. A borderline increase in fibre content (i.e. doubling of the normal density) and a relevant reduction of medullary erythropoiesis proved to be important predictors for survival, even in low‐risk classified patients, according to both clinical scores. With regard to optimal treatment strategies, patients with manifest myelofibrosis showed no significant difference in survival rates under interferon or hydroxyurea treatment. Multivariate analysis confirmed the prognostic value of histological features. A risk model based on three variables (fibre density, erythropoietic precursors and spleen size) was constructed that enabled a distinct discrimination of risk profiles. In conclusion, the presented data provide compelling evidence that bone marrow features at diagnosis exert a significant impact on prognosis in CML. In this context, the generally clinical‐based multivariate risk classification can be improved by consideration of morphological variables that are acting independently of treatment modalities.
DOI：
--
发表时间：
1972
期刊：
--
影响因子：
--
作者：
D. Cox
通讯作者：
D. Cox
严重骨髓纤维化对放化疗和同种异体骨髓移植后血液恢复的不良影响。
影响因子：
20.3
作者：
Rajantie,J;Sale,GE;Deeg,HJ;Amos,D;Appelbaum,F;Storb,R;Clift,RA;Buckner,CD
通讯作者：
Buckner,CD
慢性粒细胞白血病：患者特征和治疗与生存之间关系的多变量分析。
影响因子：
20.3
作者：
Kantarjian,HM;Smith,TL;McCredie,KB;Keating,MJ;Walters,RS;Talpaz,M;Hester,JP;Bligham,G;Gehan,E;Freireich,EJ
通讯作者：
Freireich,EJ