Results of chemotherapy by UKCCSG protocol in children with acute lymphoblastic leukemia: Clinical characteristics and outcome

摘要

Objectives: Acute lymphoblastic leukemia (ALL) represents a clonal expansion and arrest of normal lymphoid hematopoiesis. ALL remains the most common malignancy in children. The survival rate of the patients is significantly increased since the 1960s. This study was undertaken to evaluate the 5- year overall survival (OS) rates of patients with ALL in a single center in IRAN. Methodology: A total of 220 children with ALL up to 15 years old who had been treated by UKCCSG protocol at the Oncology Department in Shafa Hospital from March 1997 to October 2004 were evaluated for their age, gender, as well as FAB types, presenting features, outcomes of therapy and relapse. Results: The mean age of the patients was 6.69 years (SD= 3.8, median 6 years). In this series, 123 patients (55.9%) were male. There was a complete remission induction rate of 85.5% during first induction course of therapy. Five-year overall survival was 60.9% and it was better (p=0.006) in standard risk group. Relapse rate after first remission was 23.6% and death due to relapse was more in high risk group, but it was not significant (p=0.053). There were 59(68.6%) of total deaths in induction period and 18(20.9%) after relapse. Overall infections (69.4%) were major cause of deaths in induction period. OS was better in boys, age group between (1-10 yo) and initial white blood cells count (10,000-50,000x103/mm3) but there were not significant (p=0.39, p=0.30, p=0.202, respectively). Conclusion: Five-year overall survival was 60.9% of the children with new ALL who were undergoing chemotherapy by UKCCSG protocol. High mortality rate in induction period was mainly due to infections which decreased five-year overall survival in this study.