Prognostic Factors Analysis Ofthe Combination Of Traditional Chinese And Western Medicine Treatment Of Adult Acute Lymphoblastic Leukemia

Objective:To understand the curative effect of the combination of Chinese and western medicine treatment about adult acute lymphoblastic leukemia (ALL).And analyze the prognostic factors of adult ALL after intervention therapy of traditional Chinese medicine.In order to improve the cooperation of Chinese and western medicine treatment of adult ALL laying a foundation for clinical curative effect.Methods:Analyze the clinical data of 43 cases newly diagnosed adult ALL retrospectively in XiyuanHospital..Use Logistic-regression analysis on the treatment effect,overall survival, survival outcome and the risk of recurrence and for prognosis of single factor and multiple factors. The overall survival (OS) and event-free survival (EFS) ware analyzed by the method of Kaplan-Meier.Results:1. There are four patients during induction chemotherapy occurred early death.Complete induction chemotherapy in 39 patients with overall response rate is 89.7%.Induction chemotherapy for the first time theoverall response rate is 59.0%..2. Different sex and the age over than or equal to 35years old had no obvious effect on curative effect.There was no statistically significant difference (P>0.05).3. The different risk groups and immune classification had no obvious effect on curative effect.There was no statistically significant difference (P>0.05).4. Ph chromosome had no obvious effect on curative effect, there was no statistically significant difference (P>0.05).5. WBC≥30×109/L has no obvious effect on curative effect.There was no statistically significant difference (P>0.05).6. The intensity ofchemotherapy and presence of combined anthracycline drugs response to had obvious effect on curative effect.(P=0.022), the difference was statistically significant.But the induction chemotherapy combined with L-Asp had no obvious effect on therapy, there was no statistically significant difference (P> 0.05).7. The classification of TCM:25 cases of qi-blood deficiency,6 cases of heat into the blood,10 cases were excessive blood-heat,2 cases of blood stasis and phlegm nucleus.The effective rate of different classification of TCM had no statistically significant difference (P>0.05).8.43 patients 1 year and 3 years OS rate were 81.0% and 56.0%.1 year and 3 years of DFS rate is41.2% and 15.3%.9. Prognostic factors analysis:non-allo-HSCT therapy were independent adverse factors for mortality (OR=12.214, P=12.214). HGB<70g/L is the independent dangerous factors for 3 years OS rate (P=0.040, OR=3.920). WBC> 30 x 109/L was 3 years OS rate important prognostic factors (P=0.021, OR= 7.878);After inductive therapy non-allo-HSCT therapy was the risk factors for recurrence(P=0.019, OR=0.019); 35 years old OR is the independent factor for DFS (OR=7.143, P=7.143).Conclusion:1. TCM intervention adult ALL treatment can make the CR rate maintained at a higher level, but the long-term survival and disease-free survival effect is not obvious.2. The chemotherapy dose intensity influenced the CR rate.3. Treatment after induction therapy chose to allo-HSCT were independent prognostic factors for death, were the important factor influencing the recurrence.4. Hb<70g/L is 3 years OS independent prognostic factors for survival.WBC> 30×109/L is the important prognostic factors.5. Age 35 is DFS independent prognostic factor.