中国输血杂志2018，Vol.31Issue(2)：165-168,4.DOI:10.13303/j.cjbt.issn.1004-549x.2018.02.020
红细胞输注量为急性淋巴细胞白血病患儿3年无病生存时间的独立危险因素
The amount of the red blood cells transfused is an independent risk factor for the three-year disease-free survival in the children with acute lymphoblastic leukemia
摘要
Abstract
Objective To investigate the influence of the amount of the red blood cells transfused on the three-year disease-free survival of the children with acute lymphoblastic leukemia (ALL) . Methods A total of 678 child ALL cases were collected using a self-developed clinical blood informatic system, which covered cases from Jan, 2010 to Apr, 2013. 101 of the 678 cases involved children younger than 15 years old and were enrolled in our study. 6 indexes were used for COX regression analysis: Age, the initial diagnosis of peripheral blood WBC, immunology typing, clinical risk, the amount of the red blood cells transfused and clinical condition rating. This analysis was designed to reveal the impact of the red blood cell transfused on these children in a 3-year time frame. Results 1) Basic clinical data: Within 1—10 years, the children with a transfusion ratio of less than 0. 21 U/kg presented improved condition in primary peripheral blood WBC, T ALL and relapse compared to the ones transfused with a ratio of 0. 21 U/kg and higher. (5 /50 vs 19 /51, 3 /50 vs 16 /51, 5 /50 vs 19 /51 and 4 /50 vs 18 /51) The difference was statistically significant (P＜0. 05) . There was no statistical significance (P＞0. 05) found in sex, Hb, clinical risk, transfusion of red blood cell infection, remission and mortality (P＞0. 05); 2) The COX regression single factors analysis showed that age, immunological classification, clinical risk and the amount of red blood cell transfused had impact on the 3-year disease-free survival time of children (P＜0. 05) while no significant influence was found related to the initial diagnosis of peripheral WBC and disease relief (P＞0. 05); 3) The COX regression multiple factor analysis showed that the clinical risk degree and the amount of red blood cells transfused were statistically significant for the 3-years disease-free time in children with ALL (P＜0. 05), but age and immunological type were not (P＞0. 05); 4) The survival curve analysis showed that the 3-year disease-free survival rate of ALL children with different clinical risk (low, moderate and high risk) was 1. 0 vs 0. 84 vs 0. 42 (P＜0. 001), and the 3-year disease survival rates of children transfused with less or more than a ratio of 0. 21 U/kg of red blood cells were 0. 58 vs 0. 91 (P＜0. 01), respectively. Conclusion Both the clinical risk and the amount of red blood cell transfused are the independent risk factors for the 3-year disease-free survival time of the children with ALL. According to our results, the amount of red blood cell transfused should be reduced during the treatment.关键词
红细胞输注量/儿童急性淋巴细胞白血病患儿/3 年无病生存时间/COX 回归分析/生存曲线/临床危险度Key words
amount of red blood cell transfusion/children with acute lymphoblastic leukemia/disease-free survival of three years/COX regression multiple factors analysis/survival curve分类
医药卫生引用本文复制引用
肖昆,乐爱平,刘威,杨丽云,胡飘萍..红细胞输注量为急性淋巴细胞白血病患儿3年无病生存时间的独立危险因素[J].中国输血杂志,2018,31(2):165-168,4.基金项目
江西省科技重大项目(20144BBG70001) （20144BBG70001）
