Outcomes in Pediatric Acute Lymphoblastic Leukemia—A Single-Center Romanian Experience

Abstract

Background: This study evaluates the main (para)clinical aspects and outcomes in a group of Romanian children diagnosed with acute lymphoblastic leukemia (ALL), under the conditions of antileukemic treatment according to an adapted ALL IC Berlin–Frankfurt–Munster (BFM) 2002 protocol. Methods: We performed a retrospective single-center study of 125 children diagnosed with ALL between 2010 and 2016. Standard forms were used for data collection of variate clinical and paraclinical parameters. Results: The children were predominantly male (64.8%) and their median age at diagnosis was 5 years. A total of 107 patients were diagnosed with precursor B-cell acute lymphoblastic leukemia (BCP)-ALL and 18 with T-cell acute lymphoblastic leukemia T-ALL. Multiplex reverse transcription polymerase chain reaction RT-PCR assay for ETV6-RUNX1, BCR-ABL, E2A-PBX1, KMT2A-AFF1, and STIL-TAL1 fusion genes was performed in 111 patients. ETV6-RUNX1 translocation was detected in 18.9% of patients, while BCR-ABL1 and E2A-PBX1 rearrangements were seen in 2.7% and 3.6%, respectively. Complete remission at the end of induction phase was obtained in 89.6% of patients. The overall relapse rate was 11.2%, with 11 early and 3 late relapses. The 5-year overall survival rate in BCP-ALL was 81.6% and in T-ALL 71.4%. Conclusions: The 5-year overall and event-free survival rates in our study were slightly lower than those reported in developed countries, so the patients’ outcomes are encouraging.

Clinicolaboratory Characteristics and Outcome of Pediatric Acute Lymphoblastic Leukemia in a Resource-Limited Setting: A Study from South Egypt

“…Treatment failure was reported in 40.5% of the patients, which is the same as the study of Shibl et al in Upper Egypt and lower than Abdelmabood et al and Alecsa et al 7,26,27 , and higher than reported in SJCRH, BFM-95 and NCI 10,15,24 . This higher percentage of relapse may be due to the higher percentage of HR group in our patients.…”

Childhood acute lymphoblastic leukemia: Four years evaluation of protocols 2013 and 2016 in a single center in Indonesia, a lower‐middle‐income country

“…Similar with other studies 3,28,29,35 most relapses occurred as isolated bone marrow relapses. However, the cumulative incidence rates of isolated CNS relapses, of 8% in ALL2016 trended lower than in ALL2013 (16%) (p = .065; Figure S9).…”

“…Similar with other studies in LMICs, 3,4,9,26–29 infection was the major cause of death apart from relapse, both in ALL2013 and ALL2016. The option of antibiotic prophylaxis has been considered during induction chemotherapy 21 .…”

“…24 In our setting, the uncertainties about disease prognosis, treatment-related risks, finan-cial burden, disease-related communication, and the use of traditional medication emphasize the need for psychosocial care and assistance for families with a child with leukemia. 25 Similar with other studies in LMICs, 3,4,9,[26][27][28][29] infection was the major cause of death apart from relapse, both in ALL2013 and ALL2016. The option of antibiotic prophylaxis has been considered during induction chemotherapy.…”

Severe complications in the induction phase of therapy in a pediatric patient with T-cell acute lymphoblastic leukemia: A case report

“…[4] The 5-year overall survival for acute lymphoblastic leukemia in pediatrics after undergoing treatment is 81.6% for BCP-ALL and 71.4% for T-ALL. [5] The overall relapse rate is 11.20%. [6] We report a child with T-ALL who developed cholecystitis, hepatitis and pancreatitis during chemotherapy.…”