Childhood acute lymphoblastic leukemia managed in tertiary care center in a developing country

Dabbous, Ibrahim; Dbouk, Hassan; Sibai, Abla Mehio; Bahlawan, Lama

doi:10.1002/mpo.10139

Cited by 14 publications

(9 citation statements)

References 4 publications

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“…The overall survival rate in this initial report, which included 86 ALL patients treated with different protocols, was 75% for the low-risk group and 57% for the high-risk group. This was comparable to data from highincome countries (HICs) in that time period [12,13].…”

Section: Introductionsupporting

confidence: 87%

“…The chemotherapy in some patients might have been delayed due to neutropenia, fever, or other complications. Implementation of this risk-stratified protocol in Lebanon improved the survival rates as compared to our results of the previous era where the cure rate was 54%, the death rate 32.6%, and the mean time to death 1.4 years [12].…”

Section: Discussionsupporting

confidence: 44%

“…Cure rates are lower due to relapse, abandonment of therapy, and death from toxicity secondary to suboptimal supportive care, delayed diagnosis, and comorbid conditions [9][10][11]. In Lebanon, only one study presented pediatric ALL experience and survival results [12]. The overall survival rate in this initial report, which included 86 ALL patients treated with different protocols, was 75% for the low-risk group and 57% for the high-risk group.…”

Section: Introductionmentioning

confidence: 82%

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Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

et al. 2012

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With modern risk-adapted therapy, over 80% of children with acute lymphoblastic leukemia (ALL) in highincome countries (HICs) are cured. In countries with limited resources, however, therapy results for pediatric ALL are still not encouraging. We describe our experience in treating children with ALL using a risk-adapted protocol at a tertiary referral center in Lebanon. From May 2002 to August 2009, 111 consecutive patients 1-21 years of age with newly diagnosed ALL received the CCCL ALL protocol which was based on the St. Jude Children's Research Hospital Total XV Study. The median age at diagnosis was 5 years 5 months. The male to female ratio was 1.5. Forty-six patients received the intermediate-/high-risk arm and 65 received the low-risk arm. Only one patient (0.9%) died during induction therapy. Relapse occurred in 8 (7.2%) patients. Eight (7.2%) patients died, 4 of whom were in remission. The median follow-up of the patients was 38 months. The 5-year overall survival and event-free survival were and 88.5% (95% CI: 77.1-94.4) and 78.7% (95% CI: 69.8-88.4), respectively. Our results are comparable to those in HICs in spite of the limited resources and the relatively low socioeconomic status of the Lebanese population. Children treated on this protocol experienced significant toxicity necessitating expert supportive care, but benefited from improved cure rates and prolonged survival. Am. J. Hematol. 87:678-683, 2012. V

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Section: Introductionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 44%

Section: Introductionmentioning

confidence: 82%

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Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

et al. 2012

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“…ALL is the most common cancer in childhood, accounting for almost 30% of cases seen at the American University of Beirut Faculty of Medicine (AUBFM) Children's Cancer Institute (CCI), which is affiliated with the St Jude Children's Research Hospital (SJCRH), Memphis, TN . We have noticed that these patients, who are being treated based on the SJCRH protocol TOTAL XV, frequently suffer from chronic and severe toxicities .…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] ALL is the most common cancer in childhood, accounting for almost 30% of cases seen at the American University of Beirut Faculty of Medicine (AUBFM) Children's Cancer Institute (CCI), which is affiliated with the St Jude Children's Research Hospital (SJCRH), Memphis, TN. 4 We have noticed that these patients, who are being treated based on the SJCRH protocol TOTAL XV, frequently suffer from chronic and severe toxicities. 5 We used the candidate gene approach and showed clinically significant results whereby five variants in four candidate genes were associated with increased methotrexate (MTX)related myelotoxicity during consolidation and continuation treatment phases.…”

Section: Introductionmentioning

confidence: 99%

NUDT15 and TPMT genetic polymorphisms are related to 6‐mercaptopurine intolerance in children treated for acute lymphoblastic leukemia at the Children's Cancer Center of Lebanon

Zgheib

Akika

Mahfouz

et al. 2016

Pediatric Blood & Cancer

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The role of polymer nanolayer architecture on the separation performance of anion‐exchange membrane adsorbers: Part II. DNA and virus separations

Bhut

Weaver

Carter

et al. 2011

Biotech & Bioengineering

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The surface-initiated polymerization protocol developed in part I was used to prepare strong anion-exchange membranes with variable polymer chain graft densities and degrees of polymerization for DNA and virus particle separations. A focus of part II was to evaluate the role of polymer nanolayer architecture on DNA and virus binding. Salmon sperm-DNA (SS-DNA) was used as model nucleic acid to measure the dynamic-binding capacities at 10% breakthrough. The dynamic-binding capacity increases linearly with increasing poly ([2-(methacryloyloxy)ethyl]trimethylammonium chloride) chain density up to the highest chain density used in this study. The new membranes yielded threefold higher SS-DNA-binding capacity (30 mg/mL) than a leading commercial membrane with the same functional group chemistry. Elution of bound DNA yielded a sharp peak, and resulted in a 13-fold increase relative to the feed concentration. This concentration effect further demonstrates the highly favorable transport properties of the newly designed Q-type membranes. However, unlike findings in part I on protein binding, SS-DNA binding was not fully reversible. Minute virus of mice (MVM) was used as model virus to evaluate the virus clearance performance of newly designed Q-type membranes. Log reduction of virus (LRV) of MVM increased with increasing polymer chain density. Membranes exhibited >4.5 LRV for the given MVM impurity load and may be capable of higher LRV values, as the MVM concentration in the flow-through fraction of these samples was below the limit of detection of the assay.

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Childhood acute lymphoblastic leukemia managed in tertiary care center in a developing country

Cited by 14 publications

References 4 publications

Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

NUDT15 and TPMT genetic polymorphisms are related to 6‐mercaptopurine intolerance in children treated for acute lymphoblastic leukemia at the Children's Cancer Center of Lebanon

The role of polymer nanolayer architecture on the separation performance of anion‐exchange membrane adsorbers: Part II. DNA and virus separations

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