Objective To study the impact of peripheral blood absolute lymphocyte count ( ALC) on survival in adult patients with acute lymphoblastic leukemia ( ALL ) at the end of induction chemotherapy. Methods 122 adult patients with ALL from January 2011 to December 2017 in the Second Hospital of Shanxi Medical University were retrospectively analyzed. The impact of ALC at the end of induction and ALC ratios for relapse-free( RFS) and overall survival ( OS ) of adult ALL were analyzed. Results The study cohort was divided into the two groups according ALC-28 values ( <675cells/μL and ≥675cells/μL). The median RFS (8 months vs 12 months,P=0. 001),median OS (16 months vs 23 months,P=0. 010) between the two groups had statistically significant differ-ences. ALC-28/ALC-1 was bordered by 43％. The RFS and OS in the low ratio group were significantly shorter than those in the high ratio group (P<0. 05). ALC-28/ALC-8 was compared with 86％ cut-off. Longer RFS and OS in the higher ALC-28/ALC-8 group (all P<0. 05). Low ALC-28 was independent risk factor for RFS. Low ALC-28,and low ALC-28/ALC-1 were independent risk factors of OS. Conclusion ALC at the end of induction and ALC ratios are associated with RFS and OS of adult ALL. Higher the value,the longer the survival time.

The prognosis of acute lymphoblastic leukemia (ALL) is affected by multiple factors.As a simple and inexpensive prognostic indicator,the peripheral blood absolute lymphocyte count (ALC) is more and more concerned.Relevant studies show that ALC values of different time points during induction therapy and its ratio show important value in the assessment of ALL prognosis,which is expected to provide a basis for subsequent individualized treatment.