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儿童APL中DIC的危险因素:来自CCLG-APL2016研究的见解

Qingyuan Xu¹, Linya Wang¹, Shaoyan Hu²

¹Hematology Center, National Key Discipline of Pediatric Hematology, National Key Discipline of Pediatrics (Capital Medical University); Key Laboratory of Major Diseases in Children, Ministry of Education; Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, Xicheng District, China.

British journal of haematology

|October 23, 2025

概括

低初始血小板计数增加了患有急性血小细胞白血病 (APL) 的儿童传播性血管内凝血 (DIC) 的风险. 真实印花天然配方 (RIF) 治疗显示出对DIC的保护作用.

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
凝血障碍凝血障碍凝血障碍

背景情况:

散布性血管内凝血 (DIC) 是儿科急性血细胞瘤白血病 (APL) 的严重并发症.
识别DIC的早期风险因素对于及时干预和改善患者结果至关重要.
了解特定基因突变和治疗方式在DIC发展中的作用至关重要.

研究的目的:

在接受诱导治疗的儿科APL患者中,识别DIC的早期风险因素,特别是严重等级 (4-5).
评估初始患者特征和治疗方案对DIC发生和严重性的影响.
为了比较三氧化 (ATO) 和真-原天然配方 (RIF) 在预防DIC的疗效.

主要方法:

分析了2016年CCLG-APL研究中的186名儿科APL患者的队列.
患者根据诱导治疗期间DIC的发生和严重程度进行了分类.
采用多变量分析来确定DIC的独立风险因素和保护因素.

主要成果:

DIC发生在52.2%的患者中,7.5%的患者患有4-5级的DIC.
初始低血小板数量 (PLT ≤26×10^9/L) 是DIC (OR=2.679) 的一个独立风险因素.
实-白天然配方 (RIF) 诱导疗法显示具有保护作用 (OR=0.465).
对于4-5级的DIC,独立的风险因素包括FLT3突变 (OR=11.742),初始PLT≤26×10^9/L (OR=13.784),初始骨髓爆发≥90% (OR=5.289).

结论:

初始低血小板计数是儿科APL中DIC的重要独立风险因素.
在诱导疗法期间,RIF疗法可以作为DIC的保护因素.
FLT3突变,初始血小板数量非常低,骨髓爆炸百分比高是儿科APL中严重DIC的关键风险因素.

关键词:

在APL中,APL是APL.DIC DIC DIC DIC DIC DIC DIC DIC DIC DIC DIC DIC DIC DIC DIC DIC DIC DIC 儿科儿科儿科风险因素风险因素

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