| BackgroundAcute lymphoblastic leukemia (ALL) is a kind of malignant tumour steming from hematopoietic stem cell, caused by undifferentiated or poor differrentiated lymphocytes infinitely hyperplasia in hematopoietic tissue.On the base of different age, pathogenesis, treatment and prognosis, we divides ALL into pedia-ALL and adult-ALL. Adult-ALL is a great challenge for the researchers, though a lot of attemption has been done,5years survival rate is still in the range of30%-50%[1]. There is no standard or guideline for ALL treatment, most specialists consent to carry on the maintenance therapy, following a list of high strength induction therapy and consolidation therapy. We usually use glucocorticoids+vincristine+L-asparaginase+anthracyclines±cyclophos-phamide in induction therapy; Methotrexate is essential for consolidation therapy and maintenance therapy. These chemotherapy regimen mostly base on the research of pedia-ALL, lacking of investigation research in adult-ALL, therefore, a study about the regimens used in adult-ALL is necessary. The author makes a summative uation about the VDCLP regimen and VDLP regimen in32initial treatment adult aLL patients. Comparing the induction remission rate, overall survival (OS), relapse free survival(RFS), relapse rate and the occurrence rate of adverse reaction, due to guide the choose and amelioration of chemotherapy regimen for adult-ALL.ObjectivesComparing the induction remission rate, overall survival (OS), relapse free survival (RFS), relapse rate and the occurrence rate of adverse reaction in induction remission of32initial treatment adult aLL patients, due to get the effectiveness and the occurrence rate of adverse reaction in induction remission of different age, sex, danger level and chemotherapy regimen and to guide the choose of chemotherapy regimen for different danger level.Methods1. Take note of induction remission rate, overall survival (OS), relapse free survival (RFS), relapse rate and the occurrence rate of adverse reaction in induction remission of total sample, to get the effectiveness and the condition of adverse reaction occurrence of total sample.2. Divide the total sample into groups on the basis of age, sex, danger level and chemotherapy regimen, and compare the induction remission rate, overall survival (OS), relapse free survival(RFS), relapse rate and the occurrence rate of adverse reaction in induction remission between groups to analyse effect of age, sex, danger level and chemotherapy regimen on treatment effectiveness and prognosis.3. Divide the group in the same danger level into subgroups on the basis of different chemotherapy regimen, to analyse that will the differences occur if different chemotherapy regimen used in same-danger-level patients.4.Divide the group using the same chemotherapy regimen into subgroups on the basis of different age and sex, to get if patients use the same chemotherapy regimen, age and sex would affect the overall survival(OS) or not.Results1. Induction remission rate of the total sample is90.6%, and the1year relapse rate is48.3%. The incidence rate of grade3-4adverse reaction in induction remission is as listed below:leukocytopenia is81.25%, thrombocytopenia is81.25%, anemia is78.125%, fibrinogenopenia is21.875%.2. Group comparison of total sample2.1Groups based on ageThere is no statistically significant difference for induction remission rate, overall survival (OS), and relapse rate between two groups (p≥0.05), while the conditions of the5kinds of adverse reaction is the same.2.2Groups based on sexThere is no statistically significant difference for induction remission rate, overall survival(OS), relapse free survival(RFS)and relapse rate between two groups (p≥0.05), while the conditions of the5kinds of adverse reaction is the same.2.3Groups based on chemotherapy regimenThere is no statistically significant difference for induction remission rate, overall survival(OS), relapse free survival(RFS)and relapse rate between two groups (p≥0.05). In the5kinds of adverse reaction, three(leukocytopenia, thrombocytopenia and anemia) is statistically significant difference (p<0.05), and group VDLP is better than group VDCLP.2.4Groups based on danger levelThere is no statistically significant difference for induction remission rate, relapse free survival(RFS)and relapse rate between two groups (p≥0.05), while overall survival (OS) is statistically significant difference between two groups (p<0.05). In the5kinds of adverse reaction, three(leukocytopenia, thrombocytopenia and anemia) is statistically significant difference (p<0.05), and group low danger is better than group high danger.3. There is no statistically significant difference for overall survival (OS) between2subgroups based on chemotherapy regimen of group low danger, and so is the2subgroups based on chemotherapy regimen of group high danger.4. There is no statistically significant difference for overall survival(OS) between2subgroups based on age of group VDLP,while there is also no statistically significant difference for overall survival (OS) between2subgroups based on sex.And so is the group VDCLP.ConclusionsInduction remission rate of the total sample is90.6%, and the1year relapse rate is48.3%. There is also no statistically significant difference for effectiveness between regimen VDCLP and VDLP, but the myleosuppression VDCLP is worth than VDLP.In the age of15-60, age and sex are not the decisive factors for induction remission rate, relapse free survival (RFS), relapse rate and occurrence grade of adverse reaction. Group high level exhibits shorter overall survival(OS)and worth myleosuppression. |
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