[Evaluation of 196 patients with chronic myeloid leukemia based on a standard prognosis model].
The clinical course of 196 patients with chronic myelocytic leukemia (CML) was studied. Prognostic factors were analyzed using a standard prognostic model. From a univariate analysis of patients with nonblastic Philadelphia chromosome-positive CML, splenomegaly, bone marrow fibrosis, percentage of blasts and promyelocytes in the peripheral blood and LDH activity were shown to be factors with a significant negative influence on survival. However, age and the platelet count did not influence survival. The standard prognostic model, generated with the 4 variables (1) percentage of blasts and promyelocytes, (2) spleen size, (3) platelet count and (4) age did not provide a useful representation of risk status in this heterogenous patient population. However, the addition of further variables (LDH, additional chromosomal aberrations, percentage of basophiles/eosinophiles and percentage of bone marrow blasts) to the standard model allowed a separation into 2 patient groups: one with low and the other with intermediate to high risk. Our data support the general validity of the prognostic model; however, the applicability of the model may be compromised in hematologic centers with a heterogenous CML population due to the selection of high-risk patients. In this situation additional risk factors may have to be added to the prognostic formula.
Universität Ulm, Abteilung Innere Medizin III.
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B
Anger
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T
Schmeiser
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H
Heimpel
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Robertson
J E
JE
Sokal
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A
Ganser
F
F
Carbonell
D014408:Biomarkers, Tumor / Q000032:analysis; D001752:Blast Crisis / Q000401:mortality; D002066:Busulfan / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage; D007372:Interferons / Q000008:administration & dosage; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy / Q000401:mortality*; D015466:Leukemia, Myeloid, Chronic-Phase / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015996:Survival Rate
D014408:Biomarkers, Tumor; D007372:Interferons; D002066:Busulfan; D006918:Hydroxyurea
Evaluation von 196 Patienten mit chronischer myeloischer Leukämie anhand eines Standard-Prognose-Modells.