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目的 :总结上海市 10 a急性白血病 ( AL)的复发率及影响复发的因素。方法 :应用回顾性队列研究方法研究上海市 1984年 1月 1日 -1994年 12月 3 1日期间住院确诊的初发 AL患者中复发的 42 4例 AL患者。结果 :AL总的复发率是 5 4.4%,AL 确诊后 2 a内为复发的危险时期 ,占所有复发的 83 .5 %。Logistic回归分析发现发病时儿童 AML、成人 AL L、WBC>2 0× 10 9/L、血小板数 <5 0× 10 9/L和无正规预防性鞘内注射化疗是复发的高危因素。CCR1 是影响复发后生存期的主要预后因素 ,CCR1 <2 a的患者预后不良 ,CCR2 ≥ 2 a的患者有望长期生存。结论 :AL 确诊后 2 a内为复发的危险时期。年龄、WBC、血小板数、FAB分型、预防性鞘内注射是主要的预后因素。CCR1 >2 a则长期生存的希望比较大。
Objective: To summarize the recurrence rate of 10-year acute leukemia (AL) in Shanghai and the factors influencing relapse. Methods: A retrospective cohort study was conducted to investigate 424 patients with recurrent AL in hospital-diagnosed AL patients who were admitted to Shanghai from January 1, 1984 to December 31, 1994. Results: The overall AL recurrence rate was 54.4%. AL was the risk of relapse within 2 years after AL diagnosis, accounting for 83.5% of all recurrences. Logistic regression analysis found that the incidence of childhood AML, adult AL L, WBC> 20 × 10 9 / L, platelet count <50 × 10 9 / L and no formal preventive intrathecal chemotherapy is the risk of recurrence. CCR1 is a major prognostic factor affecting post-relapse survival, with poor prognosis in patients with CCR1 <2 years and long-term survival in patients with CCR2 ≥ 2 years. Conclusion: Within 2 years after AL diagnosis, it is a dangerous period of relapse. Age, WBC, platelet count, FAB typing, and prophylactic intrathecal injection were major prognostic factors. CCR1> 2 a long-term survival of the larger hope.