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Title: Chronic myeloid leukemia (CML): prognostic factors and survival analysis
Authors: Colleoni, Gisele Wally Braga [UNIFESP]
Chauffaille, Maria de Lourdes Lopes Ferrari [UNIFESP]
Moncau, José Eduardo Cajado [UNIFESP]
Souto, Elizabeth Xisto [UNIFESP]
Silva, Maria Regina Regis [UNIFESP]
Kerbauy, José [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Keywords: Chronic Myeloid Leukemia
Philadelphia Chromosome
Issue Date: 1-Feb-1996
Publisher: Associação Paulista de Medicina - APM
Citation: São Paulo Medical Journal. Associação Paulista de Medicina - APM, v. 114, n. 1, p. 1083-1090, 1996.
Abstract: The prognostic value of different factors upon diagnosis of CML was analysed in 45 Philadelphia (Ph1)-positive patients. The median survival was 48 months. Univariate analysis showed 5 poor prognostic factors (male sex, under 45 years-old, bone marrow blasts greater than or equal to 10 percent, blood basophils greater than or equal to 6 percent and blood eosinophils greater than or equal to 6 percent) which provided for the development of a clinical staging system: Stage I with none or one factor and a two-year survival rate of 100 percent; Stage II with two or three factors and two-year survival of 72.2 percent; and Stage III with four or five factors and two-year survival of 0 percent (p = 0.00016). Multivariate survival analysis showed that combination of blood basophilia and bone marrow blasts had the strongest predictive relationship to survival time. We conclude that a combination of pretreatment factors identifies different risk subcategories in CML patients and is helpful in assessing the overall prognosis and the treatment approach.
Avaliamos o valor prognóstico de diferentes fatores, ao diagnóstico, em 45 pacientes com LMC Ph1-positivos. A sobrevida mediana foi de 48 meses. A análise univariada identificou 5 fatores associados a pior prognóstico (sexo masculino, idade inferior a 45 anos, blastos na medula óssea maior ou igual a 10 percent, basófilos no sangue periférico maior ou igual a 6 percent e eosinófilos no sangue periférico maior ou igual a 6 percent), originando um sistema de estadiamento: estágio I com zero ou um fator e sobrevida de 100 percent em dois anos; estágio II com dois ou três fatores e sobrevida de 72,2 percent em dois anos; estágio III com 4 ou 5 fatores e sobrevida de 0 percent em dois anos (p = 0.00016). A análise multivariada demonstrou que a basofilia no sangue periférico e os blastos na medula óssea foram os fatores que melhor se correlacionaram com o tempo de sobrevida. Concluímos que a combinaçóo de fatores presentes no diagnóstico permite a identificação de diferentes grupos de risco na LMC, podendo ser útil na determinaçóo do prognóstico e na abordagem terapêutica.
ISSN: 1516-3180
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