Clinical Analysis Of 347 Patients With Acute Leukemia

Objective: To investigate the clinical and laboratory characteristics of acute leukemia in Shandong province, evaluate treatment efficacy and look for risk factors which influent early remission and overall survival time of patients, we analyzed clinical data, as well as some follow-up cases of acute leukemia in order to provide useful assessment of prognosis.Materials and methods: Collected 347 newly diagnosed patients with AL from January 1, 2005 to October 31, 2008 in Shandong Provincial Hospital .All cases were diagnosed based on morphological and staining characteristics of bone marrow cells stained with Wright-Giemsa ,and category diagnosed according to FAB classification criteria. Some specimens of bone marrow cells had immune phenotype and karyotype examination. Blood routine and liver function indicators are tested by fully automatic blood cell and biochemical analyzer.A retrospective analysis was carried out to analyze age, sex, clinical manifestations and laboratory test results of patients and to evaluate the effectiveness of chemotherapy. Conduct a telephone follow-up of patients and analyze their survival data to find risk factors of prognosis. All the data were analyzed by SPSS16.0. P <0.05 was considered statistical significant.Results: There are 264 cases of acute myeloid leukemia (AML) and 83 cases of acute lymphoblastic leukemia (ALL) in all 347 patients with acute leukemia. Male and female incidence ratio is 1.22:1 and a median age of onset is 39 years old. ALL patients are more susceptible to have extramedullary infiltration symptoms than AML patients. Patients' age and total number of peripheral blood leukocyte (WBC) are related factors which affect fever. Bleeding symptom is affected by AL sub-type, peripheral blood platelet (PLT) and the concentration of WBC. There is no difference of ABO blood group between acute leukemia patients and normal person. ALL patients are more susceptible to have liver damage. Age and the proportion of leukemia cells in bone morrow determine whether AML-non M3 patients could have early remission. The ratio of leukemia cells in blood is risk factors which affect whether ALL patients could have early remission. The median survival time of APL patients (33.9 months), is longer than that of ALL (17 months) and AML-non-M3 (11.2 months) patients. There is no statistical difference of survival curves between ALL group and the AML-non-M3 patients. The survival time of AML-non M3 patients is affected by concentration of white blood cells and platelets. At the same time , the proportion of leukemia cells in blood and liver function indicator-ALT are risk factors of survival time for APL patients. And whether the patients are splenomegaly, the concentration of white blood cells and the tumor load in bone marrow after first course of chemotherapy have impacts on the prognosis of ALL patients.Conclusion: The general incidence of AL in this region is basically the same as reported. ALL patients are more susceptible to have extramedullary infiltration symptoms than AML patients. There is no difference of ABO blood group between acute leukemia patients and normal person. The median survival time of APL patients is longer than that of ALL and AML-non-M3 patients , and the latter two groups have no statistical difference in survival curve. The risk factors affecting early remission and prognosis in three different types of AL are different. These factors are not the same as reported and further conclusion still need for clinical analysis of greater samples.