The Clinical Analysis Of 150 Newly Diagnosed Chronic Myeloid Leukemia

Objective To analysis the clinical features and laboratory characteristics of 150patients with newly diagnosed chronic myeloid leukemia(CML),and To investigate relationship between red blood cell distribution width(RDW)and tyrosine kinase inhibitor(TKI)in 111 patients with chronic phase chronic myeloid leukemia(CML-CP).MethodsRetrospective analysis of clinical data of 150 newly diagnosed CML patients admitted to our hospital from January 2010 to June 2018,collecting clinical data such as gender,age,blood routine,bone marrow,lactate dehydrogenase(LDH),uric acid(UA),hematopoiesis,spleen size,clinical manifestations,Ph chromosome,BCR-ABL gene quantification,etc.Another 96 healthy people were selected as the control group for analysis.Results1.This group of data included 150 patients who met the criteria,88males and 62 females,male:female=1.42:1.The median age is 43 years(15 to 83years old).Among them,111(74%)were newly diagnosed with CML-CP,22(14.7%)were CML-AP,and 17(11.3%)were CML-BP.Of the 111 patients with CML-CP,63were male and 48 were female,male:female=1.31:1.The median age is 44 years(15to 83 years old).2.Common clinical manifestations of CML patients at the initial visit were:physical examination found abnormal white blood cell or platelet count(90.6%),dizziness,fatigue,anorexia(58.0%),abdominal pain,abdominal distension,abdominal mass,splenomegaly(57.3%),fever,night sweats(20.6%),skin mucosa or visceral hemorrhage(10%),lower extremity edema(4.7%),lymphadenopathy,mass(3.3%),hearing loss(1.3%),osteoarthritis(1.3%).3.The blood routine of CML patients was:146 cases(97.3%)of white blood cells increased,96 cases(64%)of patients over 100×10~9/L,and 4 cases(2.7%)of normal;platelet elevation was increased in 69(46%),normal in 62(41.3%),decreased in 19(12.7%);red blood cells were normal in 47(31.3%),reduced in 103(68.7%).4.The mean red blood cell volume(MCV)of the newly diagnosed CML patients was not significantly different from the normal control group(92.55±5.15 fL vs 91.85±4.10 fL)(P>0.05);there was a significant difference between mean hemoglobin content(MCH),mean hemoglobin concentration(MCHC)and the normal control group(29.59±2.19 pg vs 30.73±1.65pg,319.51±13.77g/Lvs334.54±8.09g/L)(P<0.01).5.The red blood cell volume distribution width(RDW)was significantly different from the normal control group(18.32±2.02%vs 13.29±0.85%)(P<0.01),and the RDW value of CML patients was significantly higher than that of the normal control group.6.The serum levels of lactate dehydrogenase,uric acid,folic acid,vitamin B12,ferritin and erythropoietin in the newly diagnosed CML patients were significantly different from those in the normal control group(P<0.05).7.Among the 111 patients with newly diagnosed CML-CP,patients in the high RDW group had a poorer response to TKI than those in the low RDW group,especially in response to treatment at 3 and 6 months(P=0.0248,0.0376<0.05),independent of 12 months of treatment response(P=0.259>0.05).8.The RDW values of newly diagnosed CML-CP patients were correlated with age,WBC count,hemoglobin level,MCH,MCHC,splenomegaly and EUTOS scores(P<0.05);were not associated with gender,MCV,percentage of basophils,percentage of eosinophils,platelet count,Sokal,and Hasford scores risk stratification(P>0.05).Conclusion1.More men than women with CML,and the age of onset is younger than that of Western countries.2.The early symptoms of CML patients are atypical,and it is more common to see blood cells abnormalities in the first visit;other common clinical symptoms are:dizziness,fatigue,anorexia,abdominal pain,bloating,abdominal mass,splenomegaly,fever,night sweats,etc.3.The blood routine,lactate dehydrogenase,uric acid,folic acid,vitamin B12,ferritin,and erythropoietin levels in CML patients have their own characteristics.Combining this clinical feature can help the diagnosis and treatment of diseases.4.The RDW value of patients with newly diagnosed CML-CP can predict the therapeutic response of TKI.The higher the RDW value,the worse the TKI treatment response;high RDW values were associated with age,WBC count,blast cell ratio,hemoglobin levels,MCH,MCHC,splenomegaly,and risk stratification of the EUTOS score.