Prognosis related to staging systems for chronic lymphocytic leukemia
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Leucemia linfocítica crônica, Prognóstico, Clínica, EstadiamentoResumo
CONTEXTO: Diversas variáveis clínicas se relacionam ao prognóstico na leucemia linfocítica crônica; no entanto, o estadiamento de Binet determina melhor o prognóstico do que o estadiamento de Rai e Rai modificado. OBJETIVO: Avaliar características clínicas e laboratoriais no prognóstico da leucemia linfocítica crônica. TIPO DE ESTUDO: Estudos de correlação. LOCAL: Universidade Federal de São Paulo - Escola Paulista de Medicina / Universidade de Alfenas. PARTICIPANTES: 73 patients diagnosticados entre 1977 e 1994. VARIÁVEIS ESTUDADAS: Sexo, origem étnica, idade, linfadenomegalia, esplenomegalia, hepatomegalia, três ou mais áreas com aumento linfóide, hemoglobina, linfocitos, plaquetas. RESULTADOS: A sobrevida média dos pacientes foi 76 meses, idade média de 65 anos, variando de 33 a 87 anos. Quarenta e quatro pacientes (60,3%) eram do sexo masculino e 29 (39,7%) do sexo feminino. A análise univariada mostrou que o nível de hemoglobina (P = 0,001), número de plaquetas (P = 0,03), linfocitose periférica (P = 0,03), número de áreas linfóides acometidas (P = 0,01), assim como os estadiamentos de Rai (P = 0,02), Rai modificado (0,007) e Binet (P = 0,003) relacionaram-se significantemente com a sobrevida. A análise multivariada, pela regressão de Cox, demonstrou que o sistema de Binet determina melhor o prognóstico do que os estadiamentos de Rai e Rai modificado. CONCLUSÃO: O estadiamento de Binet é melhor que o estadiamento de Rai e Rai modificado na determinação do prognóstico.
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