Childhood acute lymphoblastic leukemia in the Middle East and neighboring countries: A prospective multi‐institutional international collaborative study (CALLME1) by the Middle East Childhood Cancer Alliance (MECCA)

Abstract

This first collaborative study has established a process for prospective data collection and future multinational collaborative research in the Middle East. Despite the limitations of an incomplete population-based study, it provides the first comprehensive baseline data on clinical characteristics, laboratory evaluation, induction outcome, and toxicity. Further work is planned to uncover possible biologic differences of ALL in the region and to improve diagnosis and management.

Immunophenotypic aberrancies in acute lymphoblastic leukemia from 282 Iraqi patients

“…The main characteristics and immunological subclasses of the patients enrolled in the current study are similar to most previous studies from the region and worldwide. Our figures for the proportion of B‐ALL and T‐ALL at 85.5%, and 14.5% are virtually identical to the 84.5% and 15.6% reported by the Middle East Childhood Cancer Alliance in 2014 . It is also consistent with most studies worldwide .…”

Acute lymphoblastic leukemia in low and middle-income countries

“…The main features that emerge are a small but significant decrease in the incidence of ETV6-RUNX 1 or t(12;21) [11 & ,12,21] and an increase in t(9 : 22) BCR-ABL [13,22 & ] compared to western countries. The main features that emerge are a small but significant decrease in the incidence of ETV6-RUNX 1 or t(12;21) [11 & ,12,21] and an increase in t(9 : 22) BCR-ABL [13,22 & ] compared to western countries.…”

Biology of childhood acute lymphoblastic leukemia (ALL) in low/middle-income countries-A case for using age at diagnosis for defining low-risk ALL

“…South Asians are by ancestry Caucasians and there is no a priori reason to anticipate that ALL biology is different in this population. Studies from the Middle East show an age peak similar to that seen in European Caucasians, and studies from Malaysia–Singapore indicate that the incidence of ETV6/RUNX1 in South Asian children is 20% . Experienced cytogeneticists point out that identification of high hyperdiploid cases is often difficult and some are loathe to exclude hyperdiploidy without looking at 100 metaphases to find the required minimum three spreads with >50 chromosomes.…”

“…Studies from the Middle East show an age peak similar to that seen in European Caucasians, and studies from Malaysia-Singapore indicate that the incidence of ETV6/RUNX1 in South Asian children is 20%. [6,7] Experienced cytogeneticists point out that identification of high hyperdiploid cases is often difficult and some are loathe to exclude hyperdiploidy without looking at 100 metaphases to find the required minimum three spreads with >50 chromosomes. The very high frequency of euploid cases in the present study (84% compared to <13.6% in the NOPHO study) suggests continuing technical issues with the leukemia cytogenetic evaluations.…”