Death Risk Factors Analysis Of Childhood Acute Lymphoblastic Leukemia Treated With CCLG-ALL2008

Objective:To analyze the death cause?death time and correlated death risk factors of childhood acute lymphoblastic leukemia(ALL)treated with CCLG-ALL2008.Methods:From march 2008 to January 2015,545 patients with ALL were diagnosed and treated with CCLG-ALL 2008 protocol in Children's Hospital Affiliated to Chongqing Medical University,of which 97 cases died,their death cause?death time AND related risk factors were analysed.Results:(1)The 5 year overall survival rate(OS)of 545 childrens with ALL was(80±1.9)%.The 5 years OS in patients with standard risk ?middle risk and high risk was(89.5±1.9)%(75.9±4.0)% and(49.1±0.64)%,the difference was statistically significant(x=82.27,P=0.00).(2)There were 52 cases death related to relapsed,of which,43 cases of simple bone marrow recurrences 5 cases of extramedullary relapse,4cases of bone marrow combined with intramedullary relapse were included;there were 3 refractory leukemia.33 patients deaded,related to Side effects of chemotherapy,called treatment related death(TRD),whichincluding 26 cases dead caused by serious infection,4 cases of Fatal hemorrhage,2 cases of Severe drug eruptions and 1 case of Severe pancreatitis;9 cases given up because of economic reasons.(3)The median survival time of 97 dead cases is 10 months(range from 1-64months),Among the 33 cases TRDs',5 case were SR,12 cases were IR and16 cases were HR.Among the 16 cases HR,3 cases were died in induction phase,2 cases in early intensive phase,10 cases in consolidation phase and 1case in late intensive phase.HR consolidation stage is the highest risk stage.Among 52 cases of death related to relapsed,29 cases were very early relapse 12 case were early relapse and 11 cases were late relapse.the very early relapse were the highest risk of death.(4)Multivariate analysis showed that High risk and age?10years were independent risk factors for death.Conclusion: 1.The CCLG-ALL 2008 regimen has a good prognosis with a 5 years OS of(80±1.9)%.2 Relapse is the main casue of death,the simple bone marrow relapse and very early relapse were the most common reason of the relapse related death.3.Infection is the most common reason of TRD,the HR consolution stage is the highest death rate period of TRD.4.High risk and age?10 years were independent risk factors for death.