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目的 :了解急性白血病 (AL)患者的一般情况、疾病本身以及化疗方案等因素对诱导缓解的影响 ,分析诱导失败的原因。方法 :患者骨髓细胞采用RHG和G带法进行染色体检测 ;以流式细胞仪检测多药耐药 1(MDR 1)的表达。将 195例AL患者按诱导缓解成功与否进行分组 ,对患者的年龄、性别、FAB分型、症状、骨髓和外周血情况、染色体改变、血清乳酸脱氢酶 (LDH)以及化疗方案等一系列指标进行比较。结果 :142例在两次诱导化疗后完全缓解 (缓解组 ) ,5 3例未缓解 (难治组 )。与缓解组相比 ,难治组急性非淋巴细胞白血病 (ANLL)患者比例、浸润症状的发生率、外周血白细胞计数和血清LDH水平、除t(8;2 1)外的其他染色体异常所占比例显著升高。去甲氧柔红霉素治疗组患者的缓解率高于其他化疗方案。结论 :AL患者的分型、浸润情况、白血病细胞负荷和生物学特性以及化疗方案的选择是导致诱导失败的重要因素
Objective: To understand the general situation of patients with acute leukemia (AL), the disease itself and chemotherapy and other factors on the induction of remission, analysis of the reasons for the failure of induction. Methods: The bone marrow cells of patients were detected by RHG and G banding method. The expression of multidrug resistance 1 (MDR 1) was detected by flow cytometry. A total of 195 patients with AL were divided into two groups according to the success of induction remission. The patients’ age, gender, FAB typing, symptoms, bone marrow and peripheral blood, chromosome changes, serum lactate dehydrogenase (LDH) The indicators are compared. Results: 142 patients achieved complete remission after two induction chemotherapy (remission group) and 53 did not remission (refractory group). Compared with the relief group, the proportion of refractory patients with acute non-lymphocytic leukemia (ANLL), the incidence of infiltrative symptoms, peripheral blood leukocyte count and serum LDH levels, other chromosomal abnormalities except t (8; 21) accounted for The proportion increased significantly. The response rate to deoxyribocine-treated patients was higher than that of other chemotherapy regimens. CONCLUSIONS: The classification, infiltration, leukemic cell burden and biological characteristics of leukemia patients and the choice of chemotherapy regimens are important factors that lead to induction failure