Clinical Observation Of 68 Patients With Hyerleukocytic Adult Acute Myeloid Leukemia

Backgrounds and aimsAcute myeloid leukemia(AML)is a malignant blood disease characterized by abnormal clonal proliferation of primordial hematopoietic stem cells or progenitor cells.All ages may occur in AML,but mainly occurs in the elderly(> 60 years).AML is usually manifested as a rapid onset of bone marrow failure,and in the absence of treatment can be weeks or months of death [1].Peripheral white blood cells(WBC)? 100 × 109 / L acute myeloid leukemia called hyperleukocytic acute myelocytic leukemia(HAML).The early mortality of this disease,poor prognosis,easy to combine leukocyte stasis,tumor lysis syndrome and coagulation abnormalities,the risk of death is extremely high,need to intervene as soon as possible.To this end,we collected 68 cases of acute myeloid leukemia(HAML)in the First Affiliated Hospital of Zhengzhou University.The clinical features were analyzed and summarized,which provided more basis and experience for the clinical diagnosis and treatment of these patients.MethodA retrospective analysis of 68 patients with HAML(non-AML-M3)at the First Affiliated Hospital of Zhengzhou University from March 2011 to April 2016 was analyzed.The early complications and prognosis were analyzed.262 cases were randomly selected at the same time.Leukemia acute myeloid leukemia(NHAML)(WBC <100 × 109 / L)as a control group,compared the clinical features and prognosis of the two groups.Result1.There were 36 males and 32 females with a male and female ratio of about 1.13: 1 and a median age of 43(14-76)years.There were 135 males and 127 females in the control group,the ratio of male to female was 1.06: 1,the median age was 45(15-80)years of age;between the two groups,gender differences were not statistically significant.There were significant differences in the ratio of white blood cells,bone marrow naive cells,lactate dehydrogenase and WHO classification between HAML patients and control group(P <0.05),the composition ratio of chromosome grouping,the chemotherapy regimen,the consolidation therapy There was no significant difference in the number of treatment(P> 0.05).2.There were significant differences in the complications of coagulation abnormality,leukocyte stasis and tumor lysis syndrome between HAML and AML-M5 type(P <0.05).3.The CR rate was 66.1%,the 3-year disease-free survival(DFS)and the overall survival(OS)were 43.5% and 30.6%,respectively,and the OS was correlated with CR(P <0.05)(P <0.01).There was no significant difference in DFS between HAML and NHAML cases(P <0.01),and there was no significant difference between the two groups(P> 0.05),and the difference was statistically significant(P <0.01)(P = 0.267).4.The prognosis of HAML cases: 56 cases of HAML cases completed induction therapy,which received complete remission(Complete remission,CR)in 37 cases(66.1%),partial remission(PR)of 7 cases(12.5%),There were 12 cases(21.4%)of non-remission(NR),and the CR rate of AML-M5 was low,and single factor analysis CR was associated with AML-M5(P <0.05).5.There were 8 cases(11.8%)of early death(ED)in HAML cases,and ED was related to coagulation abnormality,leukocytosis and LDH(P <0.01).Conclusion1.HAML patients prone to leukocyte stasis,coagulation dysfunction,tumor lysis syndrome and other serious complications,early mortality is high.2.HAML cases CR rate is low,and whether the AML-M5 type.3.There was no significant difference in the difference of CR and OS between HAML cases and NHAML cases,and there was no significant difference in DFS between three years.