Alghamdi Ashwaq T, Alead Joud E, Darwish Eman G, Matasif Shahad T, Qari Mohamad H
Cardiology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.
Pediatrics, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.
Cureus. 2022 Mar 8;14(3):e22952. doi: 10.7759/cureus.22952. eCollection 2022 Mar.
Background Acute lymphoblastic leukemia (ALL) is a hematological cancer that causes an accumulation of immature cells in the bone marrow. The count of white blood cells (WBCs) is an independent predictor of survival. Integrating first-line treatment, such as intensive chemotherapy, with prognostic factors aids in developing critical therapeutic decisions and improving long-term outcomes. This study evaluated several prognostics such as age, WBCs, ALL cell subtypes, and absolute WBC counts. Methods This study involved a retrospective record review and was conducted by scanning the medical records of all individuals who developed ALL and were on chemotherapy at a teaching Hospital in Jeddah between 2012 and 2018. The data entry was done using Microsoft Excel, while the analysis was done using SPSS Version 21. To test any associations, frequency and measure of central tendencies, t-test, and chi-square test were used. Results A total of 98 of ALL patients were on chemotherapy, and 18 were excluded. Thus, 80 patients were analyzed. The mean age for all patients was 13.6 years (range: 0.6-26.6 years), and the most frequent ages were less than 18 years (90%). More than half of them (62.5%) were males. The majority of the patients were Bangladeshi, Pakistani, Indian, Afghan, Indonesian, and Myanmar (37.7%), and the least were Saudi (3.8%). B subtype (75.9%) was more common than T subtype (24.1%). The first remission after treatment was in 66 patients, with a mean of 6.86 years. There was a significant adverse relationship between the ability of patients to reach the first remission and WBC count (p = 0.032). There was strong significant negative correlation between absolute lymphocyte count (ALC) and survival duration after treatment (r = -0.669; p = 0.012). Conclusions The impact regarding age and WBC is almost like most previous studies. ALC shows a strong poor prognosis, while ALL cell subtypes demonstrate a contradictory prognosis effect.
背景 急性淋巴细胞白血病（ALL）是一种血液系统癌症，可导致骨髓中不成熟细胞的积累。白细胞（WBC）计数是生存的独立预测指标。将一线治疗（如强化化疗）与预后因素相结合有助于制定关键的治疗决策并改善长期预后。本研究评估了年龄、白细胞、ALL细胞亚型和白细胞绝对计数等几种预后因素。方法 本研究采用回顾性记录审查，通过扫描2012年至2018年在吉达一家教学医院发生ALL并接受化疗的所有个体的病历进行。数据录入使用Microsoft Excel，分析使用SPSS 21版。为检验任何关联，使用了频率和集中趋势度量、t检验和卡方检验。结果 共有98例ALL患者接受化疗，18例被排除。因此，对80例患者进行了分析。所有患者的平均年龄为13.6岁（范围：0.6 - 26.6岁），最常见的年龄小于18岁（90%）。其中超过一半（62.5%）为男性。大多数患者为孟加拉国、巴基斯坦、印度、阿富汗、印度尼西亚和缅甸人（37.7%），最少的是沙特人（3.8%）。B亚型（75.9%）比T亚型（24.1%）更常见。治疗后的首次缓解发生在66例患者中，平均为6.86年。患者达到首次缓解的能力与白细胞计数之间存在显著的不良关系（p = 0.032）。绝对淋巴细胞计数（ALC）与治疗后的生存持续时间之间存在强烈的显著负相关（r = -0.669；p = 0.012）。结论 关于年龄和白细胞的影响与大多数先前研究几乎相似。ALC显示出强烈的不良预后，而ALL细胞亚型表现出矛盾的预后效应。
