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Objective To analyze the molecular characteristics and prognosis in acute myeloid leukemia patients with AML1/ETO.Methods The clinical data of 63 cases of acute myeloid leukemia (AML) patients with AML1/ETO positive were analyzed retrospectively.56 cases of AML patients with AML1/ETO negative in the same period were analyzed as control.Characteristics in morphology,immunology,cytogenetics,molecular biology and the clinical effects of treatment were studied and analyzed.Results M2a was 57.12 ％ (36/63),M2b was 33.33 ％ (21/63) in AML with AML1/ETO.The percent of initial marrow blasts was 0.46±0.16.The positive rate of CD34,CD13,CD33,CD19,CD7 and CD56 was 67.21％,52.46 ％,40.98 ％,63.93 ％,4.92 ％ and 50.82 ％,respectively.The rate of t(8;21) translocation was 82.54 ％.There was 4.76 ％ with additional chromosome abnormality,three cases with EV1 1and one case with MLL/AT9.The overall CR rate,the relapse rate,the 3-year and the 5-year overall survival rate was 71.43 ％,51.11％,(43.01±5.31) ％ and (32.79±3.81) ％,respectively.There was no significant difference compared with the control group (P ＞ 0.05).But extramedullary infiltration,the expression of CD56 and additional chromosome abnormality had statistical effects on overall survival (P ＜ 0.05).Conclusions There has unique characteristics in AML with AML1/ETO.The effects of treatment and the prognosis are affected by many factors,so the efficacy and prognosis of AML with AML1/ETO couldn' t just depend on AML1/ETO.
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Objective To investigate the characteristics and risk factors of hospital infection in elderly patients with acute leukemia and provide basis for its prevention and treatment. Methods The hospital infection rate,infection sites,pathogenic bacteria and infectious factors of 116 elderly patients with acute leukemia between January 1999 and January 2008 were analyzed retrospectively,and compared with groups of non-elderly patients in the corresponding period. Results The incidence of hospital infection [62.9 %(73/116)]and death[52.1 %(38/116)]in elderly patients were higher than that of non-elderly ones (P <0.01). The most commonly infective sites were oral cavity and respiratory system. The multiple and serious infection in elderly patients was more than that of non-elderly noes. The common pathogenic bacteria were mainly grant-negative one. The results of multivariate aralysis showed that the absolute neutrophil count in peripheral blood,cycles of chemotherapy,latest infections,stages of treatment,length of hospitalization and seasons on hospitalization were found as independent risk factors for hospital infection in elderly patients with acute leukemia. Conclusion The incidence of hospital infection and death in elderly patients was high. The absolute neutrophil count in peripheral blood,cycles of chemotherapy,latest infections,stages of treatment,length of hospitalization and seasons on hospitalization are independent risk factors for elderly patients with acute leukemia.
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Objective To investigate various factors influencing long-term survival of the patients with APL. Methods The clinical data of 62 cases with APL were analyzed retrospectively. Univariate and multivariate analysis of the potential factors influencing survival and prognosis were carried out with Log-Rank and Cox regression method, including sex, age, initial WBC count, initial Plt count, the level of LDH,first induction regimen, length from induction therapy to CR, and post-remission therapy. Results 62 cases were followed up for 6 to 102 months. 5-year OS and relapse-free survival (RFS) were (77.1±6.2)% and (71.4± 3.68)%, respectively.Univariate analysis revealed that initial WBC count, first induction regimen, length from induction therapy to CR and post-remission therapy were important prognostic factors for long-term survival. Multivariate analysis demonstrated that initial WBC count and post-remission therapy were associated with RFS and OS. Conclusion The post-remission therapy combining ATRA, As2O3 and chemotherapy would significantly improve the long-term survival of APL patients entering CR.