儿科急性髓性白血病和高白血细胞症,白血细胞计数大于50 × 109/L
Aoli Zhang1,2, Lipeng Liu1,2, Suyu Zong1,2
1State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300020, China.
儿科急性髓性白血病 (AML) 具有高白细胞 (WBC ≥50 × 10 ^ 9 / L) 显示了类似的生存结果,无论白细胞数值的值. 然而,高白细胞症与这些年轻患者的无事件生存率较低有关.
科学领域:
- 儿科血液学 瘤学 儿科血液学
- 白血病研究研究 白血病研究
- 在儿童癌症的临床结果.
背景情况:
- 急性骨髓性白血病 (AML) 的超白血细胞症通常与不良预后有关.
- 超白细胞瘤对儿科AML预后的具体影响尚不清楚.
- 这项研究将超白细胞症定义为白细胞 (WBC) 计数≥50×10^9/L.
研究的目的:
- 研究患有超白细胞瘤的儿科AML患者的临床特征和预后.
- 为了比较儿科AML患者与没有超白细胞瘤之间的结果.
- 分析不同白细胞计数值在患有超白细胞瘤的儿科AML的预后意义.
主要方法:
- 连续招募了132名新诊断的儿童AML患者的队列,这些患者患有高白细胞瘤.
- 数据是从2009年9月到2021年8月收集的.
- 研究了预后因素和临床结果.
主要成果:
- 在27.4%的儿科AML病例中观察到超白细胞症.
- 与没有高白细胞瘤的患者相比,患有高白细胞瘤的患者具有类似的完全缓解 (CR) 和整体存活率 (OS).
- 在患有超白细胞瘤的儿科AML患者中,无事件生存率 (EFS) 较低. 在50-100 × 10^9/L和≥100 × 10^9/L的白细胞计数之间,没有发现CR1,死亡率,复发/耐药性疾病或HSCT率的显著差异.
- FAB M5亚型与较低的生存率有关,而CBF-AML显示出良好的预后.
结论:
- 患有高白细胞瘤的儿科AML患者的预后不管WBC计数在50-100×10^9/L之间或超过100×10^9/L之间,都具有相似的预后.
- 虽然整体存活率可能相似,但超白细胞瘤在儿科AML中具有较低的无事件存活率.
- 像FAB M5这样的特定亚型需要更密切的监测,因为结果较差.
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