| Objective:Study the clinical characterstics,effect of chemotherapy and progn-osis in patients with acute leukemia transformed from myelodysplastic syndro-mes(secondary acute leukemia,sAL or MDS/AL).Methods:Thirty-one patients with MDS/AL from union hospital of fujian medic-al university were in enrolled in this study.This was a retrospective review,usi-ng WHO standard analyse the clinical characterstics,effect of chemotherapy inpatients with MDS/AL.Age,sex,LDH level,WBC count,HB,PLT count,mean pla-telet volume, bone marrow blasts before therapy, prior MDS treatment,time totransformation to AL were evaluated for their impact on complete response(CR) and overall survival (OS).Results: In these thirty-one patients,93.5%(29/31) was acute myeloidleukemia,the type was mainly M2and M5,3.2%(1/31) was acute lymphoblasticleukemia; About80.6%of MDS type was RAEB-1and RAEB-2before MDStransformation to AL. The median time from MDS diagnosis to thedevelopment of AL was8months(range:1~84months). Clinical feature wasmianly anemia,fever, haemorrhage,but less of leucocythemia cell soak outsidethe bone marrow.Bone marrow hyperplasia level mostly were activeproliferation. MDS/AL highly expressed CD34, CD1l7antigen,and there wastwo patients expressed lymphatic antigen CD56.There were twenty-fivepatients received induction therapy in these thirty-one patients.Only twenty-twopatients can be evaluated the rate of CR;27.3%(6patients) achieved CR,andthe overall effective rate was59.1%. Age,sex,LDH level, WBC count,HB,PLTcount, mean platelet volume, bone marrow blasts before therapy, prior MDStreatment, time to transformation to AL were evaluated for their impact onCR,and we found nothing(P>0.05). The median overall survival (OS) was9months (range:0-43months) of these thirty-one patients.Two years survival was6.5%, early mortality was16.1%.Survival analysis found that patients withLDH>=515U/L appeared shorter median OS when compared to patientswith LDH... |
