| Objective:Acute promyelocytic leukemia (APL) is a malignant proliferative disease originated from hematopoietic stem cells, which is also called the M3 subtype of acute non-lymphocytic leukemia. The clinical symptoms of acute promyelocytic leukemia including bleeding, abnormalities of blood coagulation function, infection and anemia. The progress of APL can be quite fast without effective treatments. However, with the wide application of all-trans retinal acid (ATRA) and arsenic trioxide (ATO), the prognosis of APL has been improved by a large margin. So far, there’s no systematic study on the long-time survive of patients with APL in Qilu hospital, neither was that on the patients of early death or relapse. Meanwhile, the quality of life (QOL) is an important aspect to evaluate the treatment effects. In the presenting study, we investigated the possible influence factors of prognosis and evaluated treatment effect by measuring the quality of life of patients in different treatment stages, analyzing the clinical data and follow-up measurement of the newly diagnosed patients with acute promyelocytic leukemia.Methods:We retrospectively analyzed the clinical data of 113 adult patients who were newly diagnosed with acute promyelocytic leukemia in Qilu Hospital from Dec 2009 to May 2015, and undertook questionnaire surveys on 34 newly-diagnosed patients, 20 post-induction therapy patients and 36 post-treatment patients by using QLQ-C30 Scale. During the treatment, blood routine, liver and kidney function, bone marrow examination, chromosome analysis and PML/RARa fusion gene index are checked regularly to monitor the patients’conditions and evaluate the treatment effects. Meanwhile SPSS 20.0 software was used to analysis the overall survival (OS), relapse free survival (RPS), and quality of life (QOL), as well as to draw the survival curves, and compare the differences of QOL in the three groups.Results:1、The CR rate of all the 113 cases was 96.36%.4 cases occurred early deaths(4.42%), 1 case failed the induction therapy. The relapse rate was 12.04%.2、In 113 patients,36 patients belong to the high-risk group when diagnosed, with a proportion of 31.86%.62 belong to the middle-risk group, with a proportion of 54.87%.15 belong to the low-risk group, with a proportion of 13.27%.3、For all the 113 cases, the average OS was 39.95±0.97months, the average RFS was 38.92±19.56 months.3-year-OS rate was 93.6%,5-year-OS rate was 91%; 3-year-RFS rate was 92.7%,5-year-OS rate was 86.6%.4、The OS and RFS of patients whose PML-RARa fusion genes turned into positive or CD34 positive were shorter. No significant difference was reached between different gender, age, LDH, time to reach CR, circles of the induction therapy, quantitative level of fusion gene, and psoriasis (p>0.05)5、Significant differences were reached between the newly-diagnosed group, post-induction therapy group, and post-treatment group in all fields including that of function, symptom, economy, and overall health status (p<0.05)Conclusion:1、The CR rate of APL patients were 96.36%. The average OS was 39.95 ± 20.97months, the average RFS was 38.92±19.56 months.3-year-OS rate was 93.6%, 5-year-OS rate was 91%; 3-year-RFS rate was 92.7%,5-year-OS rate was 86.6%. Early-death rate was 4.42%. Relapse rate was 12.04%. All the results are consistent with what reported in other studies.2、The influence factors of prognosis including positive transform of PML-RARa fusion genes and CD34 positive in patients with acute promyelocytic leukemia.3、After clinical treatment, the quality of life of the APL patients improves significantly in all fields including that of function, symptom, economy, and overall health status. |
PDF Full Text Request