背景:急性髓系白血病(AML)是一种异质性疾病。预后和生存取决于决定肿瘤行为和治疗反应的几个因素。AML的预后不良取决于几个因素:患者的年龄,性别,体重指数(BMI),基线白细胞计数,和诊断时的骨髓母细胞(BMB)细胞计数。因此,这项研究旨在确定这些因素的预后作用及其对结局的影响,以及这些预后因素在诱导化疗前后如何影响AML患者。
方法:研究设计是观察性的,回顾性记录审查。我们纳入了2013年至2019年在吉达的阿卜杜勒阿齐兹国王大学接受化疗的原发性和继发性AML患者的记录,沙特阿拉伯。数据是从医疗记录中提取的,输入到Excel表格中(微软公司,雷德蒙德,WA),并使用SPSS统计分析,第25版(IBM公司,Armonk,NY).
结果:分析42例开始化疗的AML患者。诊断时的平均年龄为35±22.2岁;52.4%为男性。首次缓解的能力因年龄组而异;21-45岁年龄组的能力和生存率更高,为75.0%。另一方面,11~20岁和46~70岁年龄组的死亡率均较高(70.0%).在年龄和治疗后生存时间(SDAT)之间观察到强烈的负相关(r=-0.618,p=0.004)。在低于和高于正常体重范围的BMI范围内,死亡发生率增加。SDAT在三组之间存在显着差异,有利于体重正常的患者(p=0.019)。我们发现BMB<5的患者死亡最多。BMB与治疗后首次缓解的天数之间存在显著负相关(p=0.033)。结论:年龄,BMI,和BMB被认为是AML患者的有效预后因素。
BACKGROUND: Acute myeloid leukemia (AML) is a heterogeneous disease. Prognosis and survival depend on several factors that determine tumor behavior and response to therapy. AML has a poor prognosis that depends on several factors: patient\'s age, gender, body mass index (BMI), baseline white blood cells count, and bone marrow blast (BMB) cell count at the time of diagnosis. Therefore, this study aimed to determine the prognostic role of these factors and their impact on outcomes, and how these prognostic factors may affect AML patients before and after induction chemotherapy.
METHODS: The study design is an observational, retrospective record review. We included records of patients diagnosed with primary and secondary AML who received chemotherapy between 2013 and 2019 at King Abdulaziz University in Jeddah, Saudi Arabia. Data were extracted from medical records, entered into an Excel sheet (Microsoft Corp., Redmond, WA), and analyzed using SPSS Statistics, version 25 (IBM Corp., Armonk, NY).
RESULTS: Forty-two AML patients who were started on chemotherapy were analyzed. The mean age at diagnosis was 35 ± 22.2 years; 52.4% were male. The ability to achieve the first remission varied according to age group; the 21-45 age group had the higher ability and survival rate of 75.0%. On the other hand, the mortality incidence was higher (at 70.0%) in both the 11-20 and the 46-70 age groups. A strong negative correlation was observed between age and survival duration after treatment (SDAT) (r = - 0.618, p = 0.004). The death incidence was increased in the BMI ranges that were under and above the normal weight range. SDAT differed significantly between the three groups in favor of the normal-weight patients (p = 0.019). We found that patients with BMB < 5 had the most deaths. There was a significant negative association between BMB and days to achieve the first remission after treatment (p = 0.033). Conclusion: Age, BMI, and BMB are considered effective prognostic factors for AML patients.