| Objective:By means of cross-sectional and retrospective cohort study,the clinical manifestations,biological characteristics,laboratory examinations and survival of newly diagnosed children with acute lymphoblastic leukemia in our hospital from 2007 to 2015 were observed.By statistically describing and analyzing the collected data,the abandonment rate,referral rate,remission rate and event-free survival rate of children in the group were calculated.In order to understand the incidence of acute lymphoblastic leukemia in children in our region and improve the level of diagnosis and treatment of acute lymphoblastic leukemia in children in our hospital,the theoretical basis was provided for better understanding the diagnosis of acute lymphoblastic leukemia,correctly evaluating the risk of children and judging the prognosis.Methods:From January 1,2007 to December 31,2015,148 newly diagnosed children with acute lymphoblastic leukemia(ALL)who visited our hospital's pediatrics were counted,and the abandonment rate,referral rate,remission rate and event-free survival rate were calculated.The three-year survival rate was calculated for children from January 1,2011 to May 31,2015,and the follow-up time was up to May 31,2018.1.Inclusion criteria:(1)age less than 14 years.(2)the criteria for diagnos-is of acute lymphoblastic leukemia in children.The diagnostic criteria were b-ased on the recommendations for diagnosis and treatment of childhood acute lymphoblastic leukemia(Third Revised Draft)-2006 or 2010 childhood acut-e lymphoblastic leukemia clinical pathway(2010 Edition).Exclusive criteria:(1)Exclusive criteria for calculating abandonment rate and transfer rate:ALL patients who had not been first diagnosed and treated in our hospital.(2)To exclude the standard of three year survival rate:Children who did not complete chemotherapy regularly and missed visits.2.Design case from table,through into the group of all children's gender,age,number of abandoned cases,to give up the hospital referral number of cases,number of transferred cases to a higher hospital,immunological typing,fusion gene,chromosome,prednisone induction test,D15,D33 bone marrow morphological examination,and compliance during treatment.3.A follow-up table was designed to summarize the clinical data of children with ALL:sex(male and female),age(0-5 years,-10 years,-14years),immunological typing(B line,T line),fusion gene,chromosome,CNSL or testicular leukemia(yes,no).The season of onset,prednisone induction test,D15 bone marrow examination(primordial lymphocyte+immature lymphocyte)(<5%,>5%)and D33 bone marrow examination(primordial lymphocyte+immature lymphocyte)(<5%,>5%)were observed.The infection,compliance,number of abandoned cases and number of transferred cases were analyzed.The abandonment rate,transfer rate,remission rate,recurrence rate,mortality rate and event free survival time were calculated.4.Statistical analysis:all statistical data are used SPSS17.0 statistical soft-ware for statistical analysis,which uses the Kaplan-Meier method to calculate the three year event free survival;and the survival curve was plotted;count data to frequency or percentage(%)were shown;correlation group the analysis using the Pearson?~2 test,P<0.05 said the difference was statistically significant.Results:From January 1,2007 to December 31,2015,148 children with acute lymphoblastic leukemia(ALL)were first diagnosed in the pediatric department of our hospital,including 87 males and 61 females,aged from 3months to 14 years old.36 cases were definitely diagnosed as giving up treatment,and 24 cases were transferred to a higher hospital for further treatment.The number of annual visits showed an upward trend,with an average annual growth rate of 17.3%,and the abandonment rate showed a downward trend.All the year round,the incidence rate increased significantly from November to January.After more than one course of treatment,88patients were able to complete the follow-up without CNSL or testicular leukemia,and 19 children had no immature cells in their peripheral blood at the first visit.Of the 88 children in the group,76 were B-ALL children and12 were T-ALL children.Among them,62 were karyotype analyzed,20 were abnormal karyotype(32.3%),10 were abnormal chromosome number and10 were abnormal chromosome structure.The total remission rate after the first induction was 95.5%,100%(49/49)in the low risk group,91.3%(21/23)in the middle risk group and 81.3%(13/16)in the high risk group.The recurrence rate was 21.6%,the death rate was 6.8%.There were 58 cases of co-infection with an infection rate of 65.9%.From January 1,2011 to May 31,2015,62 newly diagnosed children completed regular chemotherapy,with a three-year event-free survival rate of(79.0 0.05)%.Sixty-two children with ALL were divided into low-risk group,middle-risk group and high-risk group,including 31 children in low-risk group,18 children in middle-risk group and 13 children in high-risk group.The three-year event-free survival rate was 90.0 0.05%in the low-risk group.Middle-risk group:(77.8 0.10)%;High risk group:(57.1 0.13)%.Conclusion:1.The abandonment rate of children with acute lymphoblastic leukemia in this area showed a downward trend.2.The 3-year event-free survival rate of 62 children was lower than that of domestic and foreign children,and the 3-year event-free survival rate of high-risk group was lower than that of domestic and foreign children.3.The risk classification of childhood acute lymphoblastic leukemia directly affects the remission rate and prognosis... |
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