Analysis on clinical features and prognosis in 83 cases of acute lymphoblastic leukemia with central nervous system infiltration / 重庆医学

ABSTRACT

Objective To investigate the clinical features,treatment regimen and prognosis of acute lymphoblastie leukemia (ALL) complicating central nervous system leukemia (CNSL).Methods The clinical data,results of laboratory detection and imageological examination in the patients with ALL complicating CNSL in this hospital from January 2005 to January 2015 were retrospectively analyzed.Results A total of 83 cases were collected,including 52 male cases(62.65％) and 31 female cases (37.35％) with a median age of 27 (15-72) years old.Among them,19 cases were T cells ALL(T-ALL),54 eases were B cell ALL(B-ALL),3 cases were Burkitt lymphoma/leukemia,2 cases were ALL (T/B lymphocyte) and 5 cases were undefined type.The median follow-up time was 10(1-52) months.The univariate analysis results showed that the patients with high WBC count (WBC≥100× 109) at initial diagnosis or unreach complete remission (CR) after 1 treatment course had relatively poor prognosis.Receiving the radiotherapy could improve the patients' survival rate(P＜0.05).In the multivariate analysis,high WBC count at initial diagnosis was an independent prognostic factor affecting the patients' overall survival(OS) (P=0.007).Conclusion The clinical features in the patients' with ALL complicating CNSL have poor specificity,high WBC level and unreaching CR by 1 treatment course are the poor prognosis factors,and local radiotherapy has a certain significance for prolonging the patients' survival period.