Modified BFM protocol for childhood acute lymphoblastic leukemia: A retrospective analysis

Abstract

Childhood acute lymphoblastic leukemia tients were 2-10 years of age and 3 were older (ALL) has a 5-year disease-free survival (DFS) of than 10 years. Male to female ratio was 3.2:1. more than 70%. This fact is not reflected in 71.4% had L1 and 28.6% had L2 morphology. developing countries due to the lack of proper Univariate analysis factors revealed central nersupportive care. A modified version of the stan-vous system (CNS) involvement and late comdard Berlin-Frankfurt-Munich (BFM) protocol plete remission (CR) during induction as poor for pediatric ALL was developed to achieve balprognostic factors. In multivariate analysis, CNS ance between toxicity and favorable response disease (P Ͻ 0.0083) was the only prognostic rates. Modification included a dose reduction variable for prolonged DFS. All patients went of asparaginase and methotrexate during the into CR. Eleven patients have relapsed. Life table consolidation and reinduction phase. Forty-two analysis of these patients shows a 59.4% probapatients younger than 15 years of age were put bility of overall survival (OS) and a 52.5% probaon the modified BFM protocol between Novembility of DFS at 48 months. ᮊ 1997 Wiley-Liss, Inc. ber 1990 and November 1993. Thirty-nine pa-

Treatment‐related mortality in children with acute lymphoblastic leukemia in Central America

“…[6][7][8][9][10][11] However, our incidence was somewhat lower than ALL TRM rates reported in other LIC populations; studies in India, Pakistan, Brazil, and Thailand have described TRM rates between 11.5% and 16%. [12][13][14][15] It is noteworthy that, in a study conducted in Honduras of 168 children with ALL between January 1999 and January 2002, the TRM rate was 20.8%, 4 which was higher than our more recent and much larger cohort. Indeed, our results verify that TRM is decreasing over time in Central America; 11.2% of children who were diagnosed before July 1, 2004 experienced TRM versus 7.9% of children who were diagnosed after that date.…”

“…[12][13][14][15] It is noteworthy that, in a study conducted in Honduras of 168 children with ALL between January 1999 and January 2002, the TRM rate was 20.8%, 4 which was higher than our more recent and much larger cohort. Indeed, our results verify that TRM is decreasing over time in Central America; 11.2% of children who were diagnosed before July 1, 2004 experienced TRM versus 7.9% of children who were diagnosed after that date.…”

“…Whereas ALL in HICs has been associated with TRM rates of 1% to 3%, [6][7][8][9][10][11] the few studies that have investigated LICs have identified rates from 11% to 21%. 4,[12][13][14][15] In El Salvador, 12.5% of children with ALL experienced TRM. 16 Although we identified several predictors of overall TRM in the El Salvador cohort, the limited sample size precluded an analysis of the patterns and timing of TRM.…”

High Infection Related Mortality in Pakistani Children With Acute Lymphoblastic Leukaemia During Remission Induction Chemotherapy: Review of Data From a Single Institution

“…for Pakistani children. [8,9] To our knowledge, this is the first study from Pakistan reporting treatmentrelated mortality (TRM) for ALL induction therapy. Aziz et al analysed the prognostic implication of presentation characteristics and outcome analysis using a modified BFM protocol in 2002.…”

“…from Pakistan. [8,9] Recently published series from India have reported induction mortality between 2% and 25%. [10][11][12][13] Shaukat Khanum Memorial Cancer Hospital and Research Centre is a philanthropically supported, modern cancer centre in Lahore, Pakistan.…”