Clinical and Prognostic Analysis of Adult Acute Lymphoblastic Leukemia

Abstract

Objective: To analyse clinical characteristics of adult patients with acute lymphoblastic leukemia (ALL) and explore prognostic factors to provide evidence for the stratification of prognostic risk and the formulation of individualized therapy. Methods: A total of 65 adult patients with newly diagnosed ALL were reviewed. Their clinical data were collected, and their overall survival was followed up. We compared the effects of different clinical features on therapeutic efficacy and long-term prognosis. Data analysis was conducted by SPSS 25.0 statistical software. P < 0.05 was considered statistically significant. Results: A total of 65 adult patients with newly diagnosed ALL, including 31 males and 34 females, were enrolled in this study, with a median onset age of 48 (range, 18-85) years. After 1 course of induction therapy, bone marrow puncture was performed to evaluate, and further demonstrate that 49 patients achieved complete response (CR), with a total CR rate (CRR) of 75.4%. Among 65 patients, the median overall survival was 15.5 (range,1.0-100.0) months, and the median disease-free survival was 9.0 (range, 0.0-99.0) months. Survival analysis showed that worse long-term outcome was associated with age (≥60 years), haemoglobin (Hb<60g/L), platelet (PLT<30×109/L), lactic dehydrogenase (LDH≥400U/L) at initial diagnosis, CD10 negative, and failure to reach CR within 4 weeks after induction therapy, whereas timely hematopoietic stem cell transplantation (HSCT) significantly improved the survival of patients. Univariate analysis suggested that age at onset, the initial level of low PLT and high LDH, and HSCT were risk factors for 2-year OS and 2-year DFS of adult ALL patients. Moreover, multivariate analysis showed that initial PLT level was an independent risk factor for the prognosis of adult ALL patients, and CR within 4 weeks after induction and HSCT could improve patients’ overall survival. Conclusion: Long-term outcome for adult ALL patients is poor. Clinical characteristics, including elder age, severe anemia, low PLT level, high LDH level, CD10 negative and so on, make poor clinical induction effect on such patients. However, achieving CR within 4 weeks and actively accepting HSCT can significantly improve the prognosis of adult ALL.