title: [Analysis of relapse factors and risk assessment of adult acute lymphoblastic leukemia].
abstract: OBJECTIVE
  To explore the risk factors of acute lymphoblastic leukemia (ALL) recurrence in adult patients and establish a prognosis index (PI) calculation model in order to improve the prevention strategy of ALL in adults.
  
  
  METHODS
  104 adult ALL patients from Blood Diseases Hospital & Chinese Academy of Medical Sciences between August 2008 and November 2011 were enrolled. COX proportional hazards regression stratified by Dummy variable was used to set up the prediction model; Kaplan-Meier method and Log-rank test were used to estimate and compare the survival. After calculated individual PI value, patients' expected survival should be estimated by groups.
  
  
  RESULTS
  The overall median survival of adult ALL patients was 22.00 months (95% CI 17.00-27.00). COX regression analysis showed that chemotherapy group patients had a higher risk of recurrence than of ASCT group while setting treatment as the dummy variable (RR=2.052, 95%CI 0.877-4.799, P=0.007). Stratified Analysis showed that the risk factors of B-ALL recurrence in adult patients included HGB <100 g/L (RR=0.186, 95% CI 0.068-0.512, P=0.001), CNSL (RR=7.767,95% CI 2.951- 20.433, P=0.001), number of consolidation chemotherapy<3 (RR=0.445, 95% CI 0.211-0.940, P=0.034) and Ph chromosome positive (RR=2.771, 95% CI 1.353-5.674, P=0.005). Grouped by the PI value, the expected survival of each individual patient could be estimated as PI=0.58 base.
  
  
  CONCLUSIONS
  HGB, CNSL, number of consolidation chemotherapy and Ph chromosome were independent risk factors of B-ALL recurrence in adult patients. PI value could predict the survival of adult ALL patients and provide reference for individual therapy and prognostic evaluation.
authors.affiliation: Department of Eepidemiology and Health Statistics, Shanxi Medical University,Taiyuan 030001,China.
authors.forename: Pei-cui
authors.initials: PC
authors.lastname: Chen
authors.forename: Ting-yu
authors.initials: TY
authors.lastname: Wang
authors.forename: De-hui
authors.initials: DH
authors.lastname: Zou
authors.forename: Lu-gui
authors.initials: LG
authors.lastname: Qiu
authors.forename: Cui-xian
authors.initials: CX
authors.lastname: Zhang
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhang
authors.forename: Gui-fen
authors.initials: GF
authors.lastname: Liu
authors.forename: Tian-e
authors.initials: TE
authors.lastname: Luo
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology* / Q000473:pathology*; D011379:Prognosis; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult