摘要：
Objective To analyze the clinical characteristics of de novo primary AML patients with higher blast cell ratio in peripheral blood than bone marrow and its relationship with CR1. Methods The clinical data on de novo primary AML patients in Henan Provincial Tumor Hospital from January 2015 to December 2016 were ret-rospectively reviewed. Based on the proportion of blast cells in the peripheral blood and bone marrow ,the patients were divided into BHG and NBHG. All the data was analyzed respectively by Schisquare test ,rank sum test or Spearman correlation analysis according to the types of clinical data. Results As compared with NBHG patients , BHG patients had a higher rate of bleeding,palpitation,M2 subtype,FLT3-ITD mutation,and average level of LDH andα-HBDH in serum before treatment,and the difference was statistically significant(P<0.05);however, the rate of CR1,M3 and M5 subtype in BHG patients was lower than that in NBHG patients,and the difference was statistically significant(P < 0.05). The proportion of peripheral blood blast cells in patients with AML has a positive correlation with serum levels of LDH and α-HBDH(R:0.331 and 0.352,P < 0.05). Conclusions De novo primary AML patients with higher blast cell ratio in peripheral blood than bone marrow are mostly M2 subtype,easily associated with FLT3-ITD mutation,bleeding and palpitation symptoms,and they have a lower CR1rate. The proportion of blast cells in peripheral blood is positively correlated with levels of serum LDH and α-HBDH.%目的 分析外周血原始细胞比例高于骨髓的初治原发急性髓系白血病(AML)患者临床特征及其与患者第一次完全缓解(CR1)的关系.方法 回顾性分析2015年1月至2016年12月河南省肿瘤医院血液科191例初治原发AML住院患者的临床资料,根据患者外周血和骨髓原始细胞比例高低,分为外周血高于骨髓原始细胞比例组(BHG)和外周血不高于骨髓原始细胞比例组(NBHG).根据临床特征数据的类型,分别采用秩和检验、卡方检验和Spearman相关分析比较各组临床特征的差异.结果 与NBHG患者相比,BHG患者出血、心悸、M2亚型和FLT3-ITD突变比例,治疗前血清中LDH与α-HBDH水平均高于NBHG患者,差异有统计学意义(均P<0.05);BHG患者CR1、M3和M5亚型比例均低于NBHG患者,差异有统计学意义(均P<0.05);AML患者外周血原始细胞比例与患者血清中LDH与α-HBDH水平有等级正相关性(相关系数R分别为0.331与0.352,均P<0.05).结论 外周血原始细胞比例高于骨髓的初治原发AML患者多为M2亚型,易伴有FLT3-ITD突变,常见出血和心悸症状,有较低的CR1比例,且原始细胞比例与血清LDH与α-HBDH水平有等级正相关性.
