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Clinical analysis of acute leukemia associated with psoriasis

Author: WangYing
Tutor: WangJianXiang
School: Peking Union Medical College , China
Course: Internal Medicine
Keywords: Psoriasis Hematological malignancies Chronic lymphocytic leukemia Acute leukemia PhD Reproducibility Immature cells Clonal Medical Lymph nodes
CLC: R758.63
Type: PhD thesis
Year: 2008
Downloads: 104
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Abstract


[Objective] To explore the clinical features of acute leukemia associated with psoriasis patients, and prognostic factors. 【Methods】 The clinical features of our hospital 100 patients with acute leukemia associated with psoriasis patients, the efficacy and survival were analyzed retrospectively. [Results] The 100 patients were divided into three groups according to the psoriasis treatment: bimolane treatment group (35 cases), non-bimolane therapy group (45 cases), no treatment group (20 cases). Three groups of patients with psoriasis type are unusual mainly men than women, bimolane treatment group in more than 10 years duration of psoriasis patients than the other two groups (P <0.05). The leukemia subtypes cases the number of order M3> M2b> M5> M4> M4eo> of ALL> M1/M2a/M6 three groups of patients suffering from leukemia type composition than no statistically significant difference (P> 0.05), the most common are AML-M3, followed by both AML-M2b, both accounting for about 3/4 of the overall type of leukemia. 70 patients karyotype examination, chromosomal aberrations was 72.9%, 44.3% non-reproducible chromosomal aberrations. Chromosome Aberrations in the non-reproducibility of the most common is a monomer Y. The three groups of patients the proportion of non-reproducible clonal structural chromosome aberrations were 42.9%, 17.1%, 21.4%, the bimolane treatment group was significantly higher than the other two groups (P <0.05). Three groups of patients with complete remission (CR) rates were 73.3%, 89.7%, 83.3%, and a course of treatment CR rates were 56.7%, 87.2%, 66.7%, the non-bimolane one course of treatment group, the CR rate was significantly higher in the other two groups (P <0.05). Lymph nodes when the newly diagnosed psoriasis duration of more than 10 years by a lower CR rate; bleeding symptoms at diagnosis, psoriasis disease duration shorter than 10 years, patients are more likely non-bimolane treatment group achieved CR course (P <0.05). Three groups of patients, the median overall survival (OS) were August, 152 and 108, the expected 5-year OS rates were 31.2%, 60.3% and 54.6%, bimolane treatment group median OS time significantly shorter than the other two groups, 5-year OS rate is lower than the other two groups (P <0.01). Median recurrence-free survival (RFS) in the three groups, respectively, in March, 84 months and 53 months, the expected 5-year RFS were 27.2%, 58.9% and 51.6%, bimolane treatment group median RFS time shorter than the other two groups, 5-year RFS rate is lower than the other two groups (P <0.01). COX regression analysis found that newly diagnosed WBC> 10 × 10 9 / L and the number of courses required by the CR for OS independent poor prognostic factors, the naive cells the higher the proportion of newly diagnosed peripheral blood appears to reproduce the non-clonal chromosomal structure The distortion achieved CR required number of courses for RFS independent poor prognostic factors. AML-M3 patients with CR rate of 89.6% the total median OS time was 152 (0.03 to 206 months), and 5-year OS rate and RFS rates were 65.5%, 62.5%. OS time and RFS time affects both newly diagnosed WBC, peripheral blood naive cell ratio and PML / RARα follow-up (P <0.01). COX regression analysis found no significant OS and RFS time independent prognostic factors. [Conclusion] with psoriasis patients with acute leukemia AML-M3 and AML-M2b most common high incidence of abnormal karyotype prompted psoriasis may be present in patients with genetic instability. Had to used bimolane its analogues were prone to non-reproducible structural chromosome aberrations, chemotherapy, remission rate, long-term survival is poor.

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CLC: > Medicine, health > Dermatology and Venereology > Dermatology > The reason is unknown skin disease > Psoriasis (psoriasis)
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