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ID:32894445
大小:2.55 MB
页数:38页
时间:2019-02-17
《急性白血病首次诱导缓解治疗后骨髓残存原始细胞与长生存的关系》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、河北医科大学硕士学位论文急性白血病首次诱导缓解治疗后骨髓残存原始细胞与长生存的关系姓名:刘宏申请学位级别:硕士专业:内科学指导教师:任金海201203中文摘要急性白血病首次诱导缓解治疗后骨髓残存原始细胞与长生存的关系摘要目的:探讨原发初治急性白血病诱导缓解治疗末(T1:化疗第5—7天)的骨髓残留白血病细胞比例对早期疗效评估,及提高患者的长期生存的价值。方法:我院自2005年9月.2010年10月住院的初治白血病病例72例,给予标准诱导化疗方案,对诱导缓解治疗期间T1时点细胞形态学分析残留白血病细胞比例与患者完全缓解(C
2、R)率、无病生存(DFS)及总体生存(OS)的关系进行了回顾性分析。结果:①72例患者CR62例,CR率为86.1%,中位DFS为31个月,3年DFS率和OS率为45.9%及55.9%。l疗程CR忠者55例,CR率为76.4%(占CR患者的89%),无诱导缓解期死亡。②以T1时点骨髓白血病细胞比例lo%对患者分组:组1(白血病细胞3、率、DFS率、0S率均显著高于组2。结论:l在诱导缓解化疗期间通过定时骨髓像分析,评估AL的早期疗效方法简便易行,有助于个体化判断患者预后。据此个体化调整可避免过度治疗及治疗不足,从而提高患者的整体疗效和长期生存。2根据诱导缓解化疗期间不同时点残留的幼稚细胞比例,可对初治白血病患者进行精确的预后分组,对近期疗效及远期疗效均有独立的预后价值。关键词:白血病;残留白血病细胞;早期疗效;预后英文摘要rn●■●■●■ll。lneC0rreIatlonbet'WeenreslllUaltherapyandlong—termsur4、vivalin■●l'』■·●'·●leUKemICcellsasterlndUCtlonpatientswithacuteleukemiaABSTRACTobjeetive:TOexploretheimpactofthepercentageofbonemalTOWresidualleukemiccellsattheendofinductionchemotherapy(T1:day5-7ofinductiontherapy)ontheprognosisofpatientswithdenovoacuteleukemia(5、AL).Improvethelong—termsurvivalofALpatients.Methods:72casesofnewdiagnoseddenovoALtreatedwithchemotherapyregimenwereenvolledfrom2005to2010.Theimpactofthepercentageofresidualleukemiccellsattimepoint(T1)oncompleteremisson(CR)rate,diseasefreesurvival(DFS)andoveralls6、urvival(os)wereretrospectivelyanalyzed.Results:1casesofpatientswithremissionin62cases,rateofCRinpatientswas86.1%,MidianDFSwas31months.DFSandOSratesat3yearswere45.9%and55.9%,respectively.After1courseoftreatmenttherewere5patientsacquriedcompletedremmision.rateofCR7、was76.4%.(Accountingfor89%oftheCRpatients).NOpatientdiedduringinductiontherapy.2Accrodingtoresidualleukemiacellsatthepointoftheendofinductiontherapyinthebonemarrow,thepatientsweredividedintotwogroups:Group1(1eukemiacells8、re92.8%ingroupland53.3%ingroup2afterthefirstcourseofinductiontherapy,respectively.DFSand0Sratesat3yearswere71.2%and77.9%ingroup1.DFSand0Sratesat3yearswere0ingroup2.Th
3、率、DFS率、0S率均显著高于组2。结论:l在诱导缓解化疗期间通过定时骨髓像分析,评估AL的早期疗效方法简便易行,有助于个体化判断患者预后。据此个体化调整可避免过度治疗及治疗不足,从而提高患者的整体疗效和长期生存。2根据诱导缓解化疗期间不同时点残留的幼稚细胞比例,可对初治白血病患者进行精确的预后分组,对近期疗效及远期疗效均有独立的预后价值。关键词:白血病;残留白血病细胞;早期疗效;预后英文摘要rn●■●■●■ll。lneC0rreIatlonbet'WeenreslllUaltherapyandlong—termsur
4、vivalin■●l'』■·●'·●leUKemICcellsasterlndUCtlonpatientswithacuteleukemiaABSTRACTobjeetive:TOexploretheimpactofthepercentageofbonemalTOWresidualleukemiccellsattheendofinductionchemotherapy(T1:day5-7ofinductiontherapy)ontheprognosisofpatientswithdenovoacuteleukemia(
5、AL).Improvethelong—termsurvivalofALpatients.Methods:72casesofnewdiagnoseddenovoALtreatedwithchemotherapyregimenwereenvolledfrom2005to2010.Theimpactofthepercentageofresidualleukemiccellsattimepoint(T1)oncompleteremisson(CR)rate,diseasefreesurvival(DFS)andoveralls
6、urvival(os)wereretrospectivelyanalyzed.Results:1casesofpatientswithremissionin62cases,rateofCRinpatientswas86.1%,MidianDFSwas31months.DFSandOSratesat3yearswere45.9%and55.9%,respectively.After1courseoftreatmenttherewere5patientsacquriedcompletedremmision.rateofCR
7、was76.4%.(Accountingfor89%oftheCRpatients).NOpatientdiedduringinductiontherapy.2Accrodingtoresidualleukemiacellsatthepointoftheendofinductiontherapyinthebonemarrow,thepatientsweredividedintotwogroups:Group1(1eukemiacells8、re92.8%ingroupland53.3%ingroup2afterthefirstcourseofinductiontherapy,respectively.DFSand0Sratesat3yearswere71.2%and77.9%ingroup1.DFSand0Sratesat3yearswere0ingroup2.Th
8、re92.8%ingroupland53.3%ingroup2afterthefirstcourseofinductiontherapy,respectively.DFSand0Sratesat3yearswere71.2%and77.9%ingroup1.DFSand0Sratesat3yearswere0ingroup2.Th
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