The Clinical Characteristics And Prognosis Of Chronic Myeloid Leukemia

Objective:Analysis of the relationship between clinical characteristics,curative effect and prognosis of chronic myeloid leukemia patients.Methods:The clinical data of 118 patients with CML-CP were collected from the Hematology Department of the second hospital of Shanxi Medical University from January 2013 to June2018.The relationship between the clinical and biological characteristics of the patients and the rate of complete molecular response(MMR)was analyzed.The relevant factors affecting the survival period(OS)of the patients were analyzed by Cox multiple factor regression model.Results:1.Among 118 newly diagnosed CML-CP patients,62 were male and 56 were female.The ratio of male to female was 1.07:1.The median age of onset was 42 years old.The main clinical manifestations were anemia,splenomegaly,fever,asthenia,night sweat and so on.There were 67 cases of WBC>100×10~9/L,75 cases of neutrophil>50×10~9/L,26 cases of PLT>300×10~9/L,58 cases of HB<90g/L,95 cases of LDH>250U/L.There were 7 cases with myelofibrosis.One patient had additional chromosome,which was der(9).2.Among 118 patients with CML-CP,all of them were treated with tyrosine kinase inhibitor.After 12 months of clinical efficacy evaluation,67 patients(56.78%)met the best response.82 patients were treated with imatinib,reaching the MMR rate of 56.10%(46/82);36patients were treated with nilotinib,reaching the MMR rate of 58.33%(21/36).3.In 118 newly diagnosed CML-CP patients,sex,age(60 years old as the boundary),splenomegaly or not,leukocyte count(100×10~9/L as the boundary),neutrophil count(50×10~9/L as the boundary),hemoglobin(90g/L as the boundary),platelet count(300×10~9/L as the boundary),lactate dehydrogenase(250U/L as the boundary)and tyrosine kinase inhibitor(imatinib or nilotinib)were analyzed The results showed that the MMR rate of patients with platelet count?300×10~9/L was higher than that of patients with platelet count>300×10~9/L(61.96%:38.46%,P=0.002),and the MMR rate of patients with LDH?250U/L was higher than that of patients with LDH>250U/L(82.61%:50.53%,P=0.011).4.In 67 patients who have achieved MMR,the results showed that the OS rate of patients with platelet count?500×10~9/L was higher than that of patients with platelet count>300×10~9/L(P=0.001),the OS rate of patients with LDH?250U/L was higher than that of patients with LDH>250U/L(P=0.037),and the OS rate of patients with nilotinib was higher than that of imatinib(P=0.002),achieving MMR at 12 months was beneficial for patients to obtain higher OS rate(P=0.002).5.The amount of 30 patients have detected lymphocyte subsets,compared with before treatment,the percentage of CD4~+T and NK cells in patients with MMR increased,the difference was statistically significant(P=0.021;P=0.007).Conclusion:1.MMR rate was higher in CML-CP patients with low platelet count and LDH level at the initial diagnosis.2.Platelet count,LDH level,use of nilotinib and MMR at 12 months were the prognostic factors for the survival of CML-CP patients.3.CML-CP patients had abnormal cellular immune regulation function,and the cellular immune function of MMR patients was improved after TKI treatment.