Allahyari Abolghasem, Hashemi Seyed-Mehdi, Nazemian Fahimeh, Karimi Mohammad, Kazemi Mohammad-Reza, Sadeghi Masoud
Department of Hematology and Medical Oncology, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Department of Hematology and Medical Oncology, Zahedan University of Medical Sciences, Zahedan, IR Iran.
Iran J Cancer Prev. 2016 Aug 10;9(4):e5045. doi: 10.17795/ijcp-5045. eCollection 2016 Aug.
Acute lymphoblastic leukemia (ALL) is aggressive cancer, especially in adults as only 20-40% is cured with current treatment regimens.
The aim of this study is to evaluate prognostic factors and their effects on survival in ALL patients in the Northeast of Iran.
In a descriptive and retrospective study from 2009 to 2015, 48 ALL patients referred to hematology-oncology clinic. Age, sex, fever, blood group, type of ALL and consumption of amphotericin B, forms of cytogenetic, survival in the patients, WBC, hemoglobin, and platelet were checked in the first referral for every patient. The mean follow-up was 27.3 months in which 28 patients (59.3%) died. overall survival (OS) was plotted by GraphPad Prism 5 and the Log-rank test was used for analysis of survival with risk factors.
The mean age for all the ALL patients at diagnosis was 32.3 years (range, 15-71 years), and 81.3% were male. Of all patients, 62.5% had fever and 25% consumed amphotericin B. 1-, 2-, 3-, 4-, 5-year OS rates were 62.2%, 52.7%, 40.6%, 39.1%, 22.2%, respectively. 75%, 29.2% and 39.6% of patients had WBC < 20 × 10/μl, Hb < 7 g/dL and platelet < 30 × 10/μL, respectively. There was a significant difference in survival based on age (P = 0.000).
Based on the results, age > 35 years is the most prognostic factor in ALL patients. Also, patients who received amphotericin B had lower life expectancy because these patients were suffering from fungal infection or due to lack of response to antibacterial drugs, they have been treated with amphotericin B.
急性淋巴细胞白血病（ALL）是一种侵袭性癌症，在成人中尤为如此，因为目前的治疗方案仅能治愈20%-40%的患者。
本研究旨在评估伊朗东北部ALL患者的预后因素及其对生存的影响。
在一项2009年至2015年的描述性回顾性研究中，48例ALL患者被转诊至血液肿瘤诊所。对每位患者首次转诊时的年龄、性别、发热情况、血型、ALL类型、两性霉素B的使用情况、细胞遗传学形式、患者生存情况、白细胞、血红蛋白和血小板进行检查。平均随访时间为27.3个月，其中28例患者（59.3%）死亡。使用GraphPad Prism 5绘制总生存期（OS），并使用对数秩检验分析有风险因素时的生存情况。
所有ALL患者诊断时的平均年龄为32.3岁（范围为15-71岁），81.3%为男性。所有患者中，62.5%有发热，25%使用过两性霉素B。1年、2年、3年、4年、5年的OS率分别为62.2%、52.7%、40.6%、39.1%、22.2%。分别有75%、29.2%和39.6%的患者白细胞<20×10⁹/μl、血红蛋白<7 g/dL和血小板<30×10⁹/μL。基于年龄的生存情况存在显著差异（P = 0.000）。
基于研究结果，年龄>35岁是ALL患者最主要的预后因素。此外，使用两性霉素B的患者预期寿命较低，因为这些患者患有真菌感染，或者由于对抗菌药物无反应，所以接受了两性霉素B治疗。
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