| Objective:This study aims at collecting the information of acute leukemia patients who are treated at the Hematologic Department of Teaching Hospital of Fujian Medical University from OCT.1994 to DEC. 2008 and analysing their clinical features.Methods:Reviewing and analysing the clinical information of 1039 acute leukemia patients who are treated at the hospital.Results:There are 1039 acute leukemia patients treated in the hospital in the same period of time, including 614 men and 425 women. The proportion of men and women is 1.44:1 and the age ranges from 14 to 90. The middle age is 33. Among them, there are 604 (58.2%) AML patients, including 364 men and 244 women, and the proportion being 1.49:1; and 401(38.6%) ALL sufferers, with 232 men and 169 women, and the proportion being 1.37:1; as well as 15 special leukemia patients. AML sufferers account for 86.4% of the total number of cases and most of them are of M2,M3 and M5 types. Most of the immune type ALL sufferers are of B cell but L2 in morphology. The ratios of male to female and AML to ALL as well as the proportion of different FAB subtypes are similar to domestic research results. AML patients increase with age while ALL patients decrease with age. The average age of AML patients is obviously higher than that of ALL patients.In AL combined diseases, the incidence rate of DIC morbidity (22.3%) of AML patients is higher than that of ALL patients (8.0%). For DIC patients with non-M3 AML, the incidence of 9.1% does not vary much with ALL group. The incidence of cerebral hemorrhage (10.3%) for AML patients is higher than ALL patients (4.2%). The incidence of tumor lysis syndrome is roughly the same for both AML and ALL patients. The incidence rate (12.2%) of central nervous system leukemia for ALL patients is significantly higher than that of the AML patients (6.1%), and the incidence of AML patients with CNSL is highest in M5, with M2 and M3 the second and the third. They account for 89.2% of the total number of cases of myeloid leukemia CNSL. AL combined diseases are mainly chronic hepatitis, hypertension, diabetes , with hepatitis being most widespread (12.9%).At the beginning the white blood cell of ALL patients are >4.0×10^9/L,the highest proportion being <50×10^9/L, with AML patients taking up 50.2% and ALL patients 53.8%. The ALL is more than AML(11.5% and 7.3%) for high white blood cell leukemia patients. The AML is higher than A L(23.3% and 14.4%) for the patient whose white blood cell is decreasing(<4.0×10^9/L). The proportion of bone marrow proliferation activity, reduction or extreme reduction for newly diagnosed AML and ALL patients shows no significant difference. AML bone marrow hyperplasia is more active (24.5%) than in ALL group (15.7%), but less than ALL in terms of extremely active group ( 50.5% and 63.8%). The submission rate and test positive rate of fusion gene in bone marrow chromosome is lower than the advanced levels home and abroad.In Chemotherapy, the CR rate (46.4%) of a period of treatment for ALL patients is higher than for AML patients (55.3%), but no significant difference in the final CR rate (respectively, 77.0% and 83.1%) is found. Among them, final CR rate (81.7%) for M3 patients is the highest of all AML subtypes. The DA program is the most widely used initial treatment induction program for AML while VDP-based program is the most widely used initial treatment of induction for ALL. The CR rate of a period of treatment of induction chemotherapy regimen for newly diagnosed AML is high with IA (61.1%), AA (58.1%) and HA / HAA (56.7%) programs, and for ALL initial treatments the higher CR rate is found in VIP / VIAP / VILP (68.4%), VTP / VATP / VTLP (66.7%) and VCP / CVAD / Hyper-CVAD (65.0%) programs.Infection in AL patients is primary found with lung, intestinal, upper respiratory tract and mouth, the most common pathogens are Escherichia coli and Candida albicans. Relapsed / refractory group of patients with remission induction of lung and intestinal infections has a higher rate of incidence than those of the initial induction of remission, with incidence of infection in other parts showing no significant difference. Candida albicans infection rate is higher than the initial induction of remission, with no significant difference in infection rates of other pathogens. AML and ALL patients with a variety of causes of death are not statistically different (P <0.05); and in AML and ALL patients, infection is the primary cause of death (47.6% and 50% respectively), and cerebral hemorrhage is the second leading cause of death (34.5% and 28.1%).Conclusions:This study analyses the clinical features of large number of acute leukemia cases of Teaching Hospital of Fujian Medical University in the past ten years, which is to some extent representative of the situation of incidence and clinical treatment of acute leukemia. It is of positive value in guiding clinical practice. |
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