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作者为了探讨影响成人急性淋巴细胞白血病(ALL)取得完全缓解(CR)及平均缓解期(MRD)的预后因素,对来自33家医院368例ALL进行了前瞻性研究。患者年龄15-65岁,采用统一的诊断标准。给相同的强烈诱导化疗及再诱导化疗方案。结果:272例(73.9%)达到CR。降低CR率的因素是:诊断时肝脾同时肿大(P=0.004)、单纯脾大(P=0.008)及出血症状(P=0.009)。有中枢神经系统(CNS)浸润者虽然CR率较低(58.3%),但与无CNS浸润者相比无显著差异。368例平均生存期为27.5个月,5年生存率为39%。272例CR者平均生存期为58.4个月,5年生存率为49%。未达到CR者平均生存期仅7.6个月。272例CR者的MRD为24.3个月,5年持
In order to investigate prognostic factors affecting complete remission (CR) and mean remission (MRD) in adult acute lymphoblastic leukemia (ALL), 368 ALL patients from 33 hospitals were prospectively studied. Patients aged 15-65 years, using a uniform diagnostic criteria. Give the same strong induction chemotherapy and reinduction chemotherapy regimen. Results: 272 patients (73.9%) achieved CR. The factors that reduced the CR rate were: simultaneous enlargement of liver and spleen at diagnosis (P = 0.004), simple splenomegaly (P = 0.008) and bleeding symptoms (P = 0.009). Although there was a lower CR rate (58.3%) in patients with CNS infiltration, there was no significant difference compared with those without CNS infiltration. 368 patients with an average survival of 27.5 months, 5-year survival rate of 39%. The average survival time of 272 CR patients was 58.4 months, and the 5-year survival rate was 49%. The average survival of non-CR patients was only 7.6 months. 272 cases of CR patients with MRD of 24.3 months, 5-year holding