[Clinical characteristics and treatment efficacy of newly diagnosed acute leukemia in the plateau].

Objective: This study aimed to retrospectively analyze the clinical characteristics and prognosis of patients with acute leukemia in the plateau. Methods: The clinical information of patients diagnosed with acute leukemia from February 2010 to April 2023 at the People's Hospital of Tibet Autonomous Region was reviewed and collected, including blood cell count, morphology, immunophenotype, cytogenetics, and molecular data. Survival analysis was conducted to analyze the outcome of patients with acute leukemia. Results: This study enrolled 105 patients with acute leukemia, including 24 with acute lymphoblastic leukemia (ALL), 62 with acute myeloid leukemia (AML), and 19 with acute leukemia without baseline data. Of the patients with ALL, 11 underwent bone marrow testing for immunophenotype, all of whom were B-cell lineage. The main FAB subtype of patients with AML was M(2) (25/57), followed by M(3) (12/57), M(5) (6/57), M(4EO) (5/57), M(1) (4/57), M(4) (4/57), and M(0) (1/57). The complete remission rates of patients with ALL, acute promyelocytic leukemia (APL), and AML (non-APL) after one course of induction therapy were 57.1% (8/14), 100% (6/6), and 53.6% (15/28), respectively. The median event-free survival (EFS) and overall survival (OS) for patients with ALL were 2 (95% CI 0-9) and 3 (95% CI 0-9) months, respectively, with a median followup of 37 (95% CI 17-57) months. Patients with APL did not reach median EFS or OS, whereas the median EFS and OS for core binding factor AML (CBF-AML) cases were 10 (95% CI 0-21) months and 13 (95% CI 3-23) months, respectively, and patients with non-CBF-AML had inferior median EFS (2 months, 95% CI 1-3) and OS (2 months, 95% CI 1-3) (P<0.01). Patients with ALL treated from 2020 to 2023 demonstrated trends toward better EFS (P=0.16) and OS (P=0.10) than those treated from 2010 to 2019. Similarly, trends toward superior EFS (P=0.27) and OS (P=0.12) were observed in patients with AML treated from 2016 to 2023, in comparison with those treated from 2010 to 2015. Conclusion: Progress in the treatment and prognosis of patients with acute leukemia in the plateau has been observed in recent years, which can be further promoted by precision diagnosis and tailored regimens.