初诊儿童急性淋巴细胞白血病血小板计数与预后的关系研究

摘要

目的 分析初诊急性淋巴细胞白血病(ALL)患儿血小板计数情况,评估其与预后的关系.方法 选取2011年1月1日—2014年12月31日明确诊断为初治ALL,免疫分型为B系(成熟B淋巴细胞白血病除外)共计337例患儿为研究对象,按照CCLG-2008方案正规化疗.按照患儿初诊时血小板计数分为三组:<100×109/L组,(100～200)×109/L组,>200×109/L.比较各组患儿性别、年龄、初诊时骨髓幼稚细胞比例、分子生物学标志、复发率.结果 初诊时血小板计数>200×109/L组患儿年龄高于其他两组(P<0.05);血小板计数<100×109/L组患儿骨髓幼稚细胞数明显高于其他两组(P<0.05);带有不同融合基因的患儿在初诊时、D15、D33的血小板计数差异均无统计学意义(P>0.05);而初诊血小板计数越低,复发率越高(P<0.05).结论 初诊时ALL患儿血小板计数低者预后较差.%Objective To evaluate the prognostic role of the platelet count of newly diagnosed children with acute lymphoblastic leukemia. Methods 337 patients wereobserved in this study from January 2011 to December 2014 in our hospital. Their clinical and biological features were analyzed. Following up ended in October 2016, the survival status was calculated by K-M curve and prognostic factors were analyzed by COX model. Results The patients are older in higher platelet group than in other two groups (P<0.05). And there are more immature leukemia cells in the bone marrow in platelet count <100 ×109/L group (P<0.05). There were no difference between three groups in fusion gene (P>0.05). There was higher relapse rate while there was less platelet ( P<0.05). Conclusion The patients with higher platelet count have a lower relapse rate, otherwise the opposite.