中国药业2026，Vol.35Issue(12)：109-113,5.DOI:10.3969/j.issn.1006-4931.2026.12.020
三氧化二砷治疗急性早幼粒细胞白血病早期死亡风险预测模型构建及验证
Construction and Validation of a Risk Prediction Model for Early Death in Acute Promyelocytic Leukemia Treated with Arsenic Trioxide
摘要
Abstract
Objective To analyze the risk factors for early death in acute promyelocytic leukemia(APL)treated with arsenic trioxide(As2O3)and to construct a risk prediction model.Methods The clinical data of 340 APL patients treated with As2O3 in hospital from February 2020 to November 2023 were collected.The patients were randomly divided into the training set(238 cases)and the validation set(102 cases)at the ratio of 7∶3.According to their survival status within 30 d after admission,the training set was classified into the survival group and the death group.Multivariate Logistic regression analysis was used to identify risk factors for early death in the training set,based on which a risk prediction model was constructed and validated.Results Among the 340 patients,61 patients(17.94%)died.In the training set,multivariate analysis showed that age>60 years old,complicated infection,fusion gene S(+)type,high-risk stratification,complicated disseminated intravascular coagulation(DIC),white blood cell count(WBC)>10×109/L,and elevated monocyte chemoattractant protein-1(MCP-1)level were independent risk factors for early death in APL treated with arsenic trioxide(P<0.05).The risk prediction model was constructed based on these factors.Receiver operating characteristic(ROC)curve analysis was performed,and the area under the curve(AUC)was 0.871[95%CI(0.812,0.915)]for the training set and 0.842[95%CI(0.797,0.892)]for the validation set.The Hosmer-Lemeshow test was conducted,and the results were x2=0.619(P=0.510)for the training set and x2=0.641(P=0.482)for the validation set.Decision curve analysis(DCA)was performed,and the model was shown to have good clinical utility in predicting the risk of early death in patients.Conclusion Age>60 years,complicated infection,fusion gene S(+)type,complicated DIC,WBC>10×109/L,and elevated MCP-1 level are risk factors for early death in APL patients treated with arsenic trioxide.The established risk prediction model is helpful for clinicians to assess high-risk patients and reduce the occurrence of early death.关键词
三氧化二砷/急性早幼粒细胞白血病/危险因素/预测模型Key words
arsenic trioxide/acute promyelocytic leukemia/risk factors/prediction model分类
医药卫生引用本文复制引用
王笺..三氧化二砷治疗急性早幼粒细胞白血病早期死亡风险预测模型构建及验证[J].中国药业,2026,35(12):109-113,5.基金项目
四川省医学(青年创新)科研课题[Q20215]. （青年创新）
