Objective: To investigate the relationship between average interval time of chemotherapy and prognosis in patients with acute leukemia (AL) during intensive treatment.
Methods: Data of 92 newly treated adult AL patients who received chemotherapy in The First Hospital of Lanzhou University from January 2010 to June 2019 were analyzed retrospectively. The patients were divided into groups according to the average interval time of chemotherapy during intensive treatment, and its influence on prognosis was analyzed.
Results: The median interval of chemotherapy during intensive therapy was 38 (20-64) days. According to the average interval of chemotherapy, patients were divided into 4 groups, including < 30 days group, 30-39 days group, 40-49 days group and ≥ 50 days group. The 3-year overall survival (OS) rate of the four groups was (84.9±8.0)%, (73.5±8.7)%, (56.5±11.1)% and (41.8±13.6)%, respectively (P=0.008). The 3-year progression-free survival (PFS) rate of the four groups was (63.6±11.1)%, (52.8±10.2)%, (38.2±10.8)% and (14.0±9.0)%, respectively (P=0.001). After comparison between the 4 groups, it was found that OS and PFS in ≥ 50 days group were significantly shorter than those in < 30 days group (P<0.008). Multivariate analysis showed that risk stratification and average chemotherapy interval ≥ 50 days were the common adverse factors affecting OS and PFS.
Conclusion: The average chemotherapy interval ≥ 50 days during intensive therapy is an independent risk factor affecting the prognosis and survival of patients with AL. When the bone marrow is completely relieved and the peripheral hemogram recovers to an acceptable level, the consolidation therapy should be started as soon as possible. The interval < 30 days can significantly improve the prognosis compared with the interval ≥ 50 days.
题目: 急性白血病患者化疗间隔时间与预后的相关性分析.
目的: 探讨急性白血病患者强化治疗期间平均化疗间隔时间与预后的关系.
方法: 回顾性分析2010年1月至2019年6月在兰州大学第一医院接受化学治疗的92例初治成人急性白血病患者的资料，依据强化治疗期间平均化疗间隔时间进行分组并分析其对预后的影响.
结果: 强化治疗期间平均化疗间隔时间中位水平为38（20-64）d，依据化疗平均间隔时间水平将患者分为<30 d、30-39 d、40-49 d、≥50 d组，4组患者3年总生存率分别为（84.9±8.0）%、（73.5± 8.7）%、（56.5±11.1）%和（41.8±13.6）%（P=0.008），3年无进展生存率分别为（63.6±11.1）%、（52.8±10.2）%、（38.2±10.8）%、（14.0±9.0）%（P=0.001）。组间行两两比较，结果显示，≥50 d组的总生存期及无进展生存期均明显短于<30 d组（P<0.008）。多因素分析结果显示，危险度分层、平均化疗间隔时间≥50 d是影响总生存、无进展生存的共同不利因素.
结论: 强化治疗期间平均化疗间隔时间≥50 d是影响急性白血病患者预后生存的独立危险因素，在骨髓象完全缓解并在外周血象恢复到可接受治疗时，应尽快开始下一次巩固治疗，间隔时间<30 d较间隔时间≥50 d能显著改善预后.