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Nomogram predictive models for adult patients with acute lymphoblastic leukaemia based on real-world treatment outcomes

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Abstract

This study aimed to analyse the characteristics and treatment outcomes of adult patients with acute lymphoblastic leukaemia (ALL) and construct nomogram predictive models for prognosis prediction. Between January 2017 and June 2022, 462 adult patients with ALL were included in this retrospective analysis. Patients’ ages ranged from 14 to 84 years. B-cell origin was observed in 82.7% of these patients, while 17.3% of the cases were of T-cell origin. The BCR/ABL1 fusion gene was detected in 32.9% of those with B-ALL. Complete remission was achieved in 83.7% of the patients after induction chemotherapy. The median disease-free survival (DFS) and overall survival (OS) of patients were 19.0 and 39.1 months, respectively. The 5-year DFS and OS rates were 29.5% and 41.8%, respectively. The BCR/ABL1 fusion gene had a significant adverse impact on DFS and OS when patients were treated with tyrosine kinase inhibitors (TKIs) and chemotherapy; however, this effect was eliminated when patients underwent transplantation. Multivariate analysis identified that age ≥ 35 years, white blood cell count ≥ 30 × 109/L, platelet count < 100 × 109/L, failure to achieve complete remission after induction chemotherapy, positive measurable residual disease (MRD), and absence of transplantation were independent adverse prognostic factors for DFS and/or OS. Nomogram predictive models constructed by the rms package in R software based on these prognostic factors demonstrated precise predictive value. In conclusion, adult patients with ALL experience poor survival. TKIs in combination with transplantation can eliminate the adverse effects of BCR/ABL1 fusion genes on prognosis. Nomogram predictive models were accurate for prognostic prediction and will be useful in clinical practice.

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Data availability

The original data analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We greatly appreciate all patients with ALL who supported this study. We would like to thank Editage (www.editage.cn) for the English language editing.

Funding

This work was supported by Joint Funds for the innovation of science and Technology, Fujian province(2021Y9086), National Natural Science Foundation of China (U2005204,82000142), Natural Science Foundation of Fujian Province (2022J01264), Startup Fund for scientific research, Fujian Medical University (2021QH2021), and Startup Fund for scientific research, Fujian Medical University (2020QH1079).

Author information

Author notes

  1. Yi Chen, Yanxin Chen and Zhengjun Wu contributed equally to this work.

  2. This work was carried out at Fujian Medical University Union Hospital.

Authors and Affiliations

  1. Fujian Medical University Union Hospital, Fujian Provincial Key Laboratory on Hematology, Fujian Institute of Hematology, Xinquan Road 29, Fuzhou, Fujian, China

    Yi Chen, Yanxin Chen, Zhengjun Wu, Jiazheng Li, Yan Huang, Jing Zheng, Yong Wu & Jianda Hu

  2. The Second Affiliated Hospital of Fujian Medical University, Zhongshanbei Road 34, Quanzhou, Fujian, China

    Jiazheng Li & Jianda Hu

  3. Institute of Precision Medicine, Fujian Medical University, Fuzhou, Fujian, China

    Jianda Hu

  4. The Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, 817 Mid Road 602, Fuzhou, Fujian, China

    Xiaomei Peng

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  1. Yi Chen
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Contributions

Yi Chen analyzed the data and wrote the main manuscript; Yanxin Chen, Zhengjun Wu, and Jiazheng Li analyzed the data and prepared the tables and figures; Yan Huang, Xiaomei Peng and Jing Zheng collected the material; Jianda Hu and Yong Wu designed this study and revised the manuscript. All authors reviewed the manuscript.

Corresponding authors

Correspondence to Yong Wu or Jianda Hu.

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Ethical approval

(Approval of the research by an Institutional Reviewer Board: The clinical study was approved by the Institutional Reviewer Board of the Fujian Medical University Union Hospital (Ethical Approval Number: 2023KJCX090).)

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Not applicable.

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Not applicable.

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Chen, Y., Chen, Y., Wu, Z. et al. Nomogram predictive models for adult patients with acute lymphoblastic leukaemia based on real-world treatment outcomes. Ann Hematol (2024). https://doi.org/10.1007/s00277-024-05692-1

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