目的:髓系白血病(MLs)是影响髓系细胞的克隆性干细胞疾病。细胞遗传学和分子生物学研究的进展部分揭示了MLs危险因素和病理生理学的奥秘。关于发病率,危险因素,对治疗的反应,以及患者的总体生存率,研究表明不同国家之间存在差异。然而,西方注册数据是医学教科书中记载的MLs描述的基础.这项研究旨在研究中东卫生中心的MLs。埃及是中东人口最多的国家,96.6%的人口是埃及人;因此,该研究集中在埃及。
方法:从两个大型三级卫生中心的医院记录中收集468例MLs患者的数据。他们被分组为第1组(慢性粒细胞白血病,CML)和第2组(急性髓性白血病,AML);后者分为2a(原发性AML)和2b(继发性AML)。
结论:患者的中位年龄为43岁;2a组男性占优势,1组和2b组女性占优势。第1组37.2%的患者接受格列卫治疗。计划进行造血干细胞移植的组只有5%,而复发的组只有18%。在第1组和第2组患者中,25%和12%,分别,停止跟进,15%和35%死亡。ORR和总生存率为53%,27%和7%,第1组和第2组分别为0.4%。最后,这项研究表明,年轻的ML患者,女性在慢性粒细胞白血病中占主导地位,可怜的结果。这反映了种族,MLs发病率的种族和危险因素差异。
OBJECTIVE: Myeloid leukemias (MLs) are clonal stem cell disorders affecting myeloid lineage cells. Advances in cytogenetic and molecular studies partially disclosed the mystery about risk factors and pathophysiology of MLs. Regarding incidence, risk factors, response to treatment, and overall survival of patients, research showed differences among different countries. However, the Western registry data are the basis for the documented description of MLs in medical textbooks. This research aimed to study MLs in Middle Eastern health centers. Egypt has the highest population in the Middle East; furthermore, 96.6% of the population is native Egyptians; accordingly the study focused on Egypt.
METHODS: Data of 468 patients with MLs were collected from hospital records at two big tertiary health centers. They were grouped into group 1 (chronic myeloid leukemia, CML) and group 2 (acute myeloid leukemia, AML); the latter was subgrouped into 2a (primary AML) and 2b (secondary AML).
CONCLUSIONS: The median age of patients was 43 years; males predominate in group 2a and females in groups 1 and 2b. 37.2% of group 1 patients were treated with Gleevec. Hematopoietic stem cell transplantation was planned for only 5% of group 2 and 18% relapsed. Of groups 1 and 2 patients, 25% and 12%, respectively, stopped follow up, and 15% and 35% died. ORR and overall survival were 53%, 27% and 7%, 0.4% for groups 1 and 2, respectively. Conclusively, this study showed a young age of ML patients, with female predominance in CML, and poor outcome. This reflected racial, ethnic and risk factor differences in incidence of MLs.