Clinical Analysis of Surgical Treatment for Leukemia Patients with Fracture
1.Department of Orthopaedics,The Second Affiliated Hospital of Xi'an Jiaotong University
2.Department of Hematology,The Second Affiliated Hospital of Xi'an Jiaotong University
Objective To retrospectively analyze the clinical efficacy and feasibility of surgical treatment for leukemia patients with fracture.Methods There were 9 cases of acute myeloid leukemia,9 cases of acute lymphoblastic leukemia,1 case of chronic myeloid leukemia and 2 cases of chronic lymphocytic leukemia.The median age was (55±15) years (range,15~77 years).There were 6 cases of lumbar vertebra,1 cases of thoracic vertebra,2 cases of thoracic and lumbar vertebrae,4 cases of femoral neck,2 cases of femoral intertrochanteric,1 case of femoral shaft,1 case of distal femur,1 case of tibia shaft,1 case of proximal tibia,1 case of proximal humeral,1 cases of femoral and patellar.Among them,there were 15 cases with traumatic cause and 6 cases of spontaneous fracture.Leukemic cells infiltrated bone tissue in 4 cases.Preoperative and postoperative visual analogue scale(VAS) were used for pain evaluation,eastern cooperative oncology group(ECOG) for general condition score,and Musculoskeletal Tumor Society (MSTS) for functional scores.Results Procedures were successfully performed in all the patients.The local pain symptoms were significantly relieved after operation.The function recovery was fast.The satisfaction with the operation was high.The patients could take care of their daily life,and continue to receive medical chemotherapy in the later period.There was no perioperative death.The follow-up time was 3~43 months (mean,18±13 months).During the follow-up period,11 cases of leukemia had recurrence,9 cases died,and the median survival time was 6 months (3~29 months).No patient was bedridden for a long time due to fracture,and no patient had secondary fracture.The postoperative VAS score of all patients was (3.57±1.08),which was lower than (8.14±1.15) before operation,and the results were significantly different (P=0.022).The general ECOG score of (1.43±0.60) after operation was significantly improved compared with (3.38±0.59) before operation,and the results were significantly different (P=0.001).The MSTS functional scores after operation was (22.32±3.25),significantly improved compared with (11.24±2.82) before operation,and the results were significantly different (P=0.015).Conclusion Surgical treatment of leukemia patients with fracture can significantly reduce the pain of patients,restore limb function,improve their quality of life,high safety,and is conducive to the later treatment of leukemia.
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