IJHS:美国急性淋巴细胞白血病的严重程度和死亡率住院:一项基于人群的研究

2022-05-26 网络 网络

本研究显示了与住院患者ALL表现相关的严重程度和死亡率相关的趋势。这项研究证实了与老年人群相比,年轻人ALL患者的先进治疗和严重程度和死亡率的改善。

急性淋巴细胞白血病(ALL)是在骨髓、血液和髓外部位增殖淋巴样祖细胞。它是儿童人群中最普遍的癌症类型,在成人人群中也是一种毁灭性的疾病。本研究探讨了社会和该研究的目的是了解健康的社会和经济指标之间的关系及其与 ALL 患者住院严重程度和死亡风险之间的关系。

图1:在美国,急性淋巴细胞白血病患者中,按地区、种族/民族和年份划分的死亡风险率(每10,000人)

在这项回顾性研究中,使用 2016 年-2018 年国家住院患者样本 (NIS) 中 ALL 的国际疾病分类 (ICD 10) 代码 (C91.00、C91.01、C91.02) 确定了具有初级和次级诊断的住院情况. 住院结局,如 LOS、死亡率、严重程度和死亡风险、成本、诊断 (NDX)、手术次数 (NPR),根据原发性和继发性 ALL 诊断患者的种族和民族、家庭收入和患者位置进行了分析。

图2:在美国的ALL患者中,按年龄、收入四分位数和年份划分的严重风险率(每10,000人)

共有 158090 例住院治疗被确定为符合纳入标准,没有使用 ICD-10 代码进行初级或次级诊断为 ALL 的漏诊病例。就诊时的严重风险因地区而异,在新英格兰地区,极有可能(778)和功能极度丧失(2198)的发病率最高(每10K)。与其他付款人相比,未投保患者的死亡率和严重程度位居第二(614、2193)。与其他种族和族裔群体相比,非裔美国人 (711)、高加索人 (648) 和美洲原住民 (612) 人群的极端死亡风险更高。

本研究显示了与住院患者ALL表现相关的严重程度和死亡率相关的趋势。这项研究的结果表明,在基于特定群体的人口统计学指标中,呈现率逐年相对下降,死亡率较高。这项研究证实了与老年人群相比,年轻人ALL患者的先进治疗和严重程度和死亡率的改善

此外,本研究的结果可能有助于基于这些社会经济和人口统计学指标进行基于人群的患者风险分层。研究团队强调,有必要获得和发展治疗方式,以改善更老龄化的ALL患者的健康结果。它还强调,有必要评估护理方法,以确保在人口较少的地区和小城市地区的病人获得护理资源的公平分配。

 

原始出处:

Sulley S, Abimbola S, Ndanga M. Acute lymphocytic leukemia severity and mortality hospitalizations in the United States: A population-based study. Int J Health Sci (Qassim). 2022 May-Jun;16(3):4-10. PMID: 35599942; PMCID: PMC9092538.

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    2022-05-27 学医无涯

    了解一下

    0

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    2022-05-26 yangchou

    好文章,值得一读。

    0

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拓展阅读

预防性输注供者来源CD19 CAR-T细胞可减少高危B-ALL异基因移植后复发

天津市第一中心医院赵明峰教授团队开展一项研究,首次探索了高危B-ALL患者allo-HSCT后预防性输注CAR-T细胞,发现可显著降低复发率且不良事件可控。研究结果近日发表于《Leukemia》。

【Haematologica】7991例AML和ALL移植后的CNS关闭率和结局

《Haematologica》近日发表一项纳入7991例AML和ALL患者的多中心回顾性研究,以定义allo-HSCT后CNS复发的发生率和结局。

【Blood】尼洛替尼+化疗±阿糖胞苷治疗Ph+ ALL的随机研究结果

研究目的是在不影响BCR::ABL1可测量残留病(MRD,无复发生存期[RFS]的潜在替代标志物)反应深度的情况下降低毒性。

Blood Res:CYP1A1变异对急性淋巴细胞白血病风险的影响——来自最新荟萃分析的证据

CYP1A1的T3801和A2455G多态性可能会增加不同种族ALL的发病风险。因此,这两种变异应该被认为是有希望的ALL风险的生物标志物。

【AJH】Ph+ ALL完全分子学反应时异基因移植可改善生存和复发

研究纳入日本成人白血病研究组(JALSG) TKI时代前瞻性研究中注册的、诊断后3个月内获得完全分子学反应 (CMR)的患者,以对比allo-SCT和非SCT队列的治疗结局。

【Cancer】Ph+ ALL异基因移植后伊马替尼对比达沙替尼维持治疗的长期结局

国内学者联合开展一项多中心回顾性分析,纳入allo-HSCT后接受TKI维持治疗的Ph+ ALL患者,以比较伊马替尼(n=91)和达沙替尼(n=50)预防治疗对HSCT后长期结局的影响。

2023 ESMO临床实践指南:急性淋巴细胞白血病靶向治疗的应用(临时更新)

欧洲肿瘤内科学会(ESMO,European Society for Medical Oncology) · 2023-10-06

2022 国际共识:急性淋巴细胞白血病/淋巴瘤的分类

国外血液科相关专家小组 · 2022-11-24

《中国成人急性淋巴细胞白血病诊断与治疗指南(2021年版)》——Ph阳性急性淋巴细胞白血病治疗的解读与思考

国家血液系统疾病临床医学研究中心北京大学血液病研究所北京大学人民医院 · 2022-03-01