Prognostic Factors In Adult Acute Lymphoblastic Leukemia

Objective: To investigate the prognostic value of biological characteristics in adult acute lymphoblastic leukemia(ALL),and provide the basis for risk stratification and individualized treatment of all patients suffering ALL.Methods: A retrospective analysis was carried out on 184 adults newly diagnosed ALL and treated in the affiliated hospital of Qingdao University during the period from January 2006 to October 2016.Statistics was done by SPSS 20.0.Results: In this study,by the end of the follow-up period,the complete remission(CR)rate of all ALL patients was 74.5%,and the infection rate during induction chemotherapy treatment was about 89.1%.The overall recurrence rate was 69.3%,and the total mortality rate was 57.1%.The survival time was from 0.3 to 118 months with the 13 months in median survival.The median disease-free survival was 4(0~113)months,and the 1-year DFS rate was 22.8%.Single factor analysis showed that the unfavorable prognostic factors included age?35,time to achieve CR?4 weeks,without preventive intrathecal injection,extramedullary leukemic cell infiltration,adenosine deaminase(ADA)?40U/L,history of hepatitis B and recurrence within 3 months.Hematopoietic stem cell transplantation(HSCT)can significantly improve prognosis.The others had no significant effect on the prognosis of adult ALL patients.By multivariate analysis,age,time to achieve CR,preventive intrathecal injection were independent prognostic factors in adult ALL patients.Conclusions: The prognosis and overall survival in adult ALL is still poor because of the high recurrence rate.HSCT can significantly improve curative effect.Age,extramedullary leukemic cell infiltration,history of hepatitis B,ADA,time to achieve CR,preventive intrathecal injection,early recurrence and HSCT were related with the prognosis of adult ALL patients.Age,time to achieve CR and preventive intrathecal injection were the independent risk prognostic factors in adult with ALL.