Analysis Of Prognostic Factors In Ph Chromosome Positive Acute Lymphoblastic Leukemia

Objective: This study aimed to explore the differences between p190 and p210,and the potential prognostic factors in Ph chromosome positive acute lymphoblastic leukemia,therefore improve the diagnosis and treatment,prolong the survival time and improve the quality of life.Methods: We collected the clinical data of 22 patients with Ph+ALL who were newly diagnosed in our hospotal from January 2013 to June 2016.SPSS 21.0 was used for data analysis.Results: The blood type in p190 group were mainly A and B,while the blood type in p210 group was mainly O.The p190 group had lower median platelet count than the p210 group (P = 0.046);the leukemic blast cells in the peripheral blood at diagnosis was higher in the p190 group than that in the p210 group (P = 0.092); the other clinical features such as age, gender, white blood cells, hemoglobin, leukemic blast cells in the bone marrow, hepatomegaly, splenomegaly, lymphadenectasis showed no differences between the group p190 and p210.The complete remission (CR) rate were 83.33% and 70% respectively in the p210 and p190 group,and there was no significant difference between the two group(P = 0.624). The recurrence rate were 50% and 57.14% in the p210 and p190 group respectively, and no significant difference was seen (P = 1.000). However, the recurrence time of the p190 group was earlier than that of p210 group (P = 0.077).The analysis of prognostic factors: Ph+ALL patients with initial white blood cell(WBC) count≤100×109/L had a better overall survival compared with that WBC>100×109/L (P = 0.006). The overall survival of p210 group was superior to p190 group, but there was no significant difference (P = 0.093).The patients treated with hematopoietic stem cell transplantation(HSCT) had a better overall survival than that who were not treated with HSCT (P = 0.028). Other clinical features such as age,initial leukemic blast cells, myeloid antigen expression, additional chromosomal abnormalities were not seen significantly correlated with prognosis.Conclusion: Compared with p210 group, the p190 group tended to have lower median platelet count and higher leukemic blast cells in the peripheral blood at diagnosis. There was no significant difference in CR rate and recurrence rate between the two groups, but the recurrence time of p190 group was earlier than that of p210 group. P190 positive, initial WBC count exceeding 100×109/L and no HSCT were correlated with poor prognosis. The blood type in p190 group were mainly A and B,while the blood type in p210 group was mainly O.Whether there was any correlation between BCR-ABL isoforms and ABO blood type could be further studied.