Objective: To sum up the long-term survival rate and prognostic factors in acute leukemia in Shanghai.
Methods: Retrospective cohort study and survival analysis.
Results: In the recent decade, 1,028 patients with acute leukemia were enrolled in Shanghai. One hundred fifty patients had 5-year long-term survival. The 5-year long-term survival rate was 18.6% for all the cases, being 13.3% for acute myeloid leukemia and 28.1% for acute lymphocytic leukemia. Children, lower white blood cell count, higher blood platelet count, lower percentage of blast cell in peripheral blood and no DIC and FAB-M(3) were protective factors for long-term survival. The remission induction regimens such as DA (daunorubicin and cytarabine) and HA (homoharringtonine and cytarabine) had no relation to long-term survival. There was no difference between the median survival time of the group with chemotherapy time less than 3 years and the group more than 3 years for acute myeloid leukemia. However, the median survival time was shorter in the group with chemotherapy time less than 3 years for acute lymphocytic leukemia.
Conclusions: The 5-year survival rate for acute leukemia was 18.6%. L(1) and M(3) subtype had better prognosis. The following prognostic factors were highly associated with long-term survival: age, white blood cell count, blood platelet count, blast cell proportion in peripheral blood, DIC and FAB classification at the time of diagnosis. DA and HA regimen had the same effect. The total chemotherapy time was recommended to be 3 years for acute myeloid leukemia and 3 - 5 years for acute lymphocytic leukemia.