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目的:分析诱导化疗期骨髓象检查结果与预后的关系。方法:对96例原发、初治急性髓细胞白血病(AML)患者,于诱导化疗第1疗程期间定时作骨髓穿刺检查。结果:化疗第7天骨髓中幼稚细胞≤0.10的患者1个疗程完全缓解(CR)率明显高于幼稚细胞>0.10的患者(分别为64.6%和40%,P<0.05)。对幼稚细胞>0.10的患者适当延长化疗时间可提高1个疗程CR率(50%∶25%,但与不延长化疗组相比无统计学差异)。停化疗后WBC降至最低时骨髓中幼稚细胞比例和预后更具显著相关性,幼稚细胞≤0.10的患者1个疗程CR率明显高于幼稚细胞>0.10的病例(66.0%∶25.8%,P<0.005),而难治病例发生率显著减少(7.5%∶45.2%,P<0.005)。结论:诱导化疗期定时骨髓象检查有助于估计预后、指导治疗和改善疗效。
Objective: To analyze the relationship between bone marrow findings and prognosis in induction chemotherapy. METHODS: Ninety-six patients with primary and newly diagnosed acute myeloid leukemia (AML) were subjected to bone marrow biopsy during the first course of induction chemotherapy. RESULTS: The complete remission (CR) rate was significantly higher in patients with immature cells <0.10 in bone marrow on day 7 after chemotherapy than in patients with immature cells >0.10 (64.6% and 40%, respectively), P<0. .05). Prolonging the chemotherapy time for patients with a naïve cell > 0.10 increased the CR rate by 1 course (50%: 25%, but was not statistically different from the non-prolonged chemotherapy group). The percentage of immature cells in the bone marrow was significantly correlated with the prognosis when WBC was reduced to a minimum after chemotherapy was stopped. The CR rate of one course of treatment for patients with immature cells ≤ 0.10 was significantly higher than that of cases with immature cells > 0.10 (66.0%). : 25.8%, P<0.005), while the incidence of refractory cases was significantly reduced (7.5%: 45.2%, P<0.005). CONCLUSIONS: Timed bone marrow imaging during induction chemotherapy can help estimate prognosis, guide treatment, and improve outcomes.