Huang Zou Fang, Wang Ting Yu, Fu Ming Wei, Liu Wei, Hao Mu, Qiu Lu Gui, Zou De Hui
Department of Lymphoma Center,State Key Laboratory of Experimental Hematology,Institute of Hematology and Blood Diseases Hospital,CAMS and PUMC,Tianjin 300020,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2019 Aug 30;41(4):485-491. doi: 10.3881/j.issn.1000-503X.10807.
To analyze the treatment and prognosis of T cell acute lymphoblastic leukemia(T-ALL)in adults. Method The clinicobiogical and survival data of 68 adult patients with newly diagnosis T-ALL were retrospectively analzyed. Results The median age of these 68 patients was 23 years(14-60 years).T-ALL was more common in men(81%).After the first cycle of treatment,complete remission was achieved in 50 patients(73%).The highest complete remission(CR) rate was in patients with cortex T-ALL(100%),followed by other T-ALL(73%)and early T-cell precursor lymphoblastic leukemia(54%),(=5.712,=0.058).The CR rate for adults aged >35 years was significantly lower than that of patients aged ≤ 35 years(40% 79%,=6.364,=0.012).The overall CR rate after the second treatment course was 93%.For patients treated with chemotherapy,autograft hematopoietic stem cell transplantation(auto-SCT),and allogeneic SCT,the median relapse free survival was 10 months,24 months,and not reached,respectively(=0.002).The 5-year overall survival rate was 25% for all patients;for patients treated with chemotherapy,auto-SCT and allogeneic SCT,the median overall survival was 24 months,34 months,and 30 months,respectively(=0.007),and the 5-year overall survival rate was 9%,33%,and 38%(=0.037).Multivariate analysis showed leukocyte count ≥100×10 /L was a risk factor for decreased relapse free survival(risk ratio 2.540,95%=1.058-6.099,=0.037). Conclusion Adult T-ALL patients have poor prognosis,which may be improved by SCT.
分析成人T细胞急性淋巴细胞白血病（T-ALL）的治疗及预后。方法 回顾性分析68例新诊断的成人T-ALL患者的临床生物学及生存数据。结果 这68例患者的中位年龄为23岁（14 - 60岁）。T-ALL在男性中更为常见（81%）。首个治疗周期后，50例患者（73%）达到完全缓解。完全缓解（CR）率最高的是皮质T-ALL患者（100%），其次是其他T-ALL（73%）和早期T细胞前体淋巴细胞白血病（54%），（χ² = 5.712，P = 0.058）。年龄＞35岁成人的CR率显著低于年龄≤35岁的患者（40% 对79%，χ² = 6.364，P = 0.012）。第二个疗程后的总CR率为93%。接受化疗、自体造血干细胞移植（auto-SCT）和异基因SCT治疗的患者，中位无复发生存期分别为10个月、24个月和未达到（χ² = 0.002）。所有患者的5年总生存率为25%；接受化疗、auto-SCT和异基因SCT治疗的患者，中位总生存期分别为24个月、34个月和30个月（χ² = 0.007），5年总生存率分别为9%、33%和38%（χ² = 0.037）。多因素分析显示白细胞计数≥100×10⁹/L是无复发生存期降低的危险因素（风险比2.540，95%CI = 1.058 - 6.099，P = 0.037）。结论 成人T-ALL患者预后较差，自体造血干细胞移植可能改善预后。
