Outcome of adult patients with acute lymphoblastic leukaemia receiving the MRC UKALL XII protocol: a tertiary care centre experience

摘要

Introduction:Acute lymphoblastic leukaemia (ALL) is a heterogeneous group of lymphoid neoplasm resulting from the proliferation of malignant lymphoid cells. We aimed to study the outcome of adult Patients with ALL receiving the Medical Research Council UKALL XII protocol.Methods:This was a retrospective study conducted at Aga Khan University Hospital from January 2001 to December 2008. The medical records of all adult Patients were reviewed and analysed for clinical, morphological and immunological features at presentation and impact on treatment outcomes. Multivariate analysis and survival studies were performed using Kaplan-Meier statistics.Results:The total number of Patients was 54, with a male to female ratio of 3.4:1 and a median age of 28 years. Common presenting symptoms were fever (n is 49) and bleeding (n is 14). 38 Patients had haemoglobin less than 10 gms/dl, 21 had white blood cell (WBC) count of 50 x 10E9/L or more, and 35 had lactate dehyrogenase more than 1,000 IU. Morphologically, FAB-L2 was the commonest subtype, with 38 Patients with B-ALL and eight with T-ALL. Multivariate analysis showed that age above 30 years, male gender, WBC count above 50 x 10E9/L and T-ALL subtype were independent risk factors for poor survival. 46 (85 percent) Patients achieved complete remission. The median survival was 12.3 months. At the end of five years, 16 Patients were alive, two were alive with disease and 14 were in complete remission.Conclusion:Overall survival and relapse rates in our study were comparable to those reported internationally.