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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

Lancet 子刊 | 高温天气与儿童急性淋巴细胞白血病风险相关性研究

研究分析了31万份样本后指出,孕早期暴露于高温环境(特别是在妊娠第8周左右)与儿童ALL风险增加有关。

【NEJM】贝林妥欧单抗治疗成人MRD阴性急性淋巴细胞白血病的3期研究结果

研究对 BCP-ALL 患者在 MRD 阴性缓解后分组治疗,贝林妥欧单抗联合化疗组总生存期显著提高,不良事件发生率有差异,<55 岁患者似获益最大。

JAMA:帕纳替尼与伊马替尼在费城染色体阳性急性淋巴细胞白血病的一线治疗中的比较

在新诊断为Ph+ ALL的成人患者中,与伊马替尼联合低强度化疗相比,帕纳替尼在诱导结束时显示出更高的MRD阴性完全缓解率。帕纳替尼的安全性与伊马替尼相当

Ann Med:CAR - T细胞治疗复发或难治性B细胞急性淋巴细胞白血病的疗效和安全性的综合分析——系统回顾和荟萃分析

选择一种更有效、更安全的CAR - t细胞疗法对于提高急性白血病患者的总生存率至关重要。除了有希望的抗cd22 CAR - t细胞外,探索共刺激结构域和新的CD靶点可以提高r/r B-ALL的治疗效果

Nature子刊重磅综述:急性淋巴细胞白血病(诊断和治疗部分)

研究讨论了 ALL 的流行病学、机制、诊断和治疗,以及 ALL 的最新进展,强调了在改善患者结局和生活质量方面的创新方法。

Nature子刊重磅综述:急性淋巴细胞白血病(流行病学和机制部分)

研究讨论了 ALL 的流行病学、机制和诊断,以及 ALL 的最新进展,强调了在改善患者结局和生活质量方面的创新方法。

2024 ELN建议:成人急性淋巴细胞白血病的诊断、预后因素及评估

欧洲白血病网(ELN,European LeukmiaNet) · 2024-05-09

2024 ELN建议:成人急性淋巴细胞白血病(ALL)的管理

欧洲白血病网(ELN,European LeukmiaNet) · 2024-05-09

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

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