The Analysis On The Factors Affecting The Long-term Survival Of Acute Promyelocytic Leukemia Treated With Compound Huangdai Tablts

BackgroundAcute promyelocytic leukemia(APL)is a special type of acute myeloid leukemia,with special clinical manifestations,such as cell morphology,immunophenotype and genetic characteristics.APL is characterized by serious bleeding tendency,it is very easy to cause bleeding and embolism,even DIC in the course and it could cause the rapid progress of the disease.So APL in the early stage is dangerous and the mortality rate is high.With the understanding of the biological characteristics and pathogenesis of APL,the treatment of APL has made a major breakthrough in the field of leukemia treatment in recent years.The use of all-trans retinoic acid(ATRT),targeted drugs such as arsenic oxide(ATO)and arsenic agent of traditional Chinese medicine make APL as a curable malignant blood disease.even had gained high total remission rate(CR)and thebetter curative effect,the long-term continuous complete remission and long-term survival of APL patients is still a hot topic of current research.ObjectiveCompound Huangdai Table(CHT)invented by our hospital,is a pure traditional Chinese medicine preparation,which has become the first-line treatment drug in APL in China.We evaluated the efficacy of CHT in the APL treatment and the influencing factors of long-term survival of APL by statistical analysis of the efficacy and influencing factors.MethodsThe data from 231 APL patients treated with CHT were analyzed from January 1988to October 2018,including age,sex,leukocyte and platelet count at initial diagnosis,risk stratification,morphological division of promyelocytic cells,CR1 days,number of early childhood granulocytes in bone marrow,whether complicated with DIC,the number of postoperative treatment sessions.The total remission(CR)rate,total survival time(OS)and non-recurrence survival rate(RFS)were calculated and the factors that might affect the prognosis of patients were statistically analyzed by X~2 test.Results1.From January 1,1986 to December 31,2017,231 APL patients obtained CR,the recurrence rate was 13.33%,12 patients died after recurrence,the mortality rate was 60%,7 cases was obtained CR again,and the CR2 rate was 35%.The 5-year OS rate is91.37%and the 5-year RFS rate is 86.33%,these data indicate that the program is an effective and feasible post-CR treatment program.2.If the post remission treatment periods<10 sessions,the RFS rate of 66.76%,OS rate was 78.52%,the periods?10 sessions,the RFS rate and OS rate were 94.44%,97.22%respectivly,and the difference was statistically significant(P<0.05).The number of post-CR courses is the influencing factors affecting the long-term survival of APL.3.In this study,there was no statistically significant analysis of the proportion of leukocyte,platelet number,abnormal early childhood granulocytes in bone marrow,complicated with DIC and acute promyelocytic cytology,etc.(P>0.05).ConclusionsThe therapy therods that firstly Utilizing CHT to obtain remission then using CHT and chemotherapy alternativly as a post remission therapy is an effective treatment for long-term survival of APL patients.Post remission treatment>10 sessions can effectively improve the RFS rate and OS rate,which is a factor affecting long-term survival.While factors including the gender,age,white blood cells,the number of platelets,the proportion of abnormal promyelocytic cells in the bone marrow at the initial diagnosis,DIC etc.did not affect the long-term survival of patients in our study,which demonstrated the rationality and effectiveness of the CHT.