摘要
目的分析细胞毒治疗相关髓系肿瘤(MN-pCT)患者的临床特征及实验室结果,以提高对该类疾病的认识,协助临床诊疗。方法回顾性分析2011年1月至2022年6月该院诊断为MN-pCT患者22例的临床特征及相关实验室结果,其中细胞毒治疗相关急性髓系白血病(AML-pCT)16例,细胞毒治疗相关骨髓增生异常综合征(MDS-pCT)5例,细胞毒治疗相关骨髓增生异常综合征/骨髓增殖性肿瘤(MDS/MPN-pCT)1例。结果22例MN-pCT患者中,原发疾病以恶性肿瘤为主19例(86.36%),其次为自身免疫性疾病3例(13.64%)。不同年龄、原发疾病、治疗方式、染色体核型及血常规降低情况患者的潜伏期比较,差异均无统计学意义(P>0.05)。AML-pCT不同预后情况患者间性别、年龄、血红蛋白水平、中性分叶核粒细胞计数、血小板计数、乳酸脱氢酶(LDH)水平、外周血原始细胞比例及潜伏期比较,差异无统计学意义(P>0.05);AML-pCT组患者的骨髓原始细胞比例及LDH水平高于MDS-pCT组(P<0.05),而两组患者其余临床资料及实验室检查结果比较,差异无统计学意义(P>0.05)。结论MN-pCT患者病死率高、预后差,综合实验室检查与临床特征有助于及时发现并诊治MN-pCT,改善患者预后。
Objective To analyze the clinical features and laboratory results of patients with myeloid neo-plasms post cytotoxic therapy(MN-pCT)and strengthen the understanding of MN-pCT to assist in clinical di-agnosis and treatment.Methods The clinical features and laboratory results of 22 patients with MN-pCT in the hospital from January 2011 to June 2022 were retrospectively reviewed,including 16 patients with acute myeloid leukaemia post cytotoxic therapy(AML-pCT),5 patients with myelodysplastic syndromes post cyto-toxic therapy(MDS-pCT)and 1 patient with myelodysplastic/myeloproliferative neoplasms post cytotoxic therapy(MDS/MPN-pCT).Results Among 22 patients with MN-pCT,19 cases of magnilant tumors(86.36%)were the main type of primary disease,followed by 3 cases of autoimmune diseases(13.64%).The incubation period had no statistically significant difference between patients in different ages,with different primary diseases,treatment methods,chromosome karyotypes and cytopenias(P>0.05).The gender,age,he-moglobin levels,neutrophilic granulocyte segmented form ratio,blood platelet counts,lactate dehydrogenase(LDH)levels,propotions of peripheral blood blasts and incubation periods among good prognosis group,mod-erate prognosis group and poor prognosis group had no statistically significant differnence(P>0.05).Com-pared with the MDS-pCT group,the proportion of bone marrow blasts and LDH level in the MDS-pCT group were higher(P<0.05),but there was no statistically significant difference in the other clinical features and laboratory results between the two kinds of patients(P>0.05).Conclusion MN-pCT patients have high mortality and poor prognosis,the combination of laboratory examination and clinical features is helpful in ear-ly detection and treatment of MN-pCT in order to improve the prognosis.
作者
陈楠
陈朴
朱建锋
张岚
张莉
潘柏申
郭玮
王蓓丽
CHEN Nan;CHEN Pu;ZHU Jianfeng;ZHANG Lan;ZHANG Li;PAN Baishen;GUO Wei;WANG Beili(Department of Laboratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China)
出处
《检验医学与临床》
CAS
2023年第9期1185-1189,1193,共6页
Laboratory Medicine and Clinic
基金
国家自然科学基金面上项目(81972000、82172348)
国家自然科学基金青年科学基金项目(81902139)
上海市临床重点专科建设项目(医学检验科、ZK2019B28)
厦门市医疗卫生重点项目(YDZX20193502000002)
复旦大学附属中山医院临床研究专项基金项目(2018ZSLC05、2020ZSLC54)。
