Survival outcome in childhood acute lymphoblastic leukemia in India

Yadav, Satya Prakash; Kalra, Manas; Madasu, Anjan; Anupam, Sachdeva

doi:10.1002/pbc.22273

Cited by 8 publications

(7 citation statements)

References 3 publications

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“…31 Zinc also decreases the duration and severity of FN. 32 Tamam et al found that poor socioeconomic status was a risk factor for FN (OR 4.59; 95%CI 1.078 to 15.08; P=0.032), while we did not. 9 This difference may be due to most of our patients were covered by the National Health Insurance System to finance either hospitalization or polyclinic treatment.…”

Section: Discussioncontrasting

confidence: 84%

Impact of malnutrition on febrile neutropenia in children with acute lymphoblastic leukemia during induction phase chemotherapy

Agnes

Widjajanto

Damayanti

2018

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Background Acute lymphoblastic leukemia (ALL) is the most common malignancy in children and adolescents. Febrile Neutropenia (FN) is a medical emergency on ALL that often leads to death. Nutrition status assessment on ALL patient is important because malnutrition can reduce the tolerance of chemotherapy, increase incidence of infection and decrease survival rate. Objectives To assess malnutrition as a risk factor for FN in children with ALL. Methods This case-control study was performed at Sardjito Hospital, Yogyakarta on patients aged 1 month to 18 years diagnosed with ALL and undergoing induction phase chemotherapy between January 2013 and December 2015. The case and control subjects were children with and without FN, respectively. Febrile neutropenia was confirmed by patients temperature above 38ºC at one measurement and a peripheral neutrophil count of less than 1,000/mm3. Malnutrition was defined as body weight-for-height was between -2 and <-3 standard deviation. Subjects were included using simple random sampling. Result Bivariate analysis showed a significant correlation between malnutrition and FN (OR 2.62; 95%CI 1.07 to 6.45; P=0.03). However, there was no inverse correlation between socioeconomic status and FN (OR 1.1; 95%CI 0.42 to 2.41; P=0.83). There was no correlation between nutritional status and duration of FN (P= 0.48). Conclusion Malnutrition is a risk factor for FN in children with acute lymphoblastic leukemia.

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Section: Discussioncontrasting

confidence: 84%

Impact of malnutrition on febrile neutropenia in children with acute lymphoblastic leukemia during induction phase chemotherapy

Agnes

Widjajanto

Damayanti

2018

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“…Many patients stop therapy soon after diagnosis due to cost, distance, ignorance, and girl child [2,3]. So far,acute lymphoblastic leukemia has shown improved outcome of 60% to 74% from India [4]. But sepsis remains a huge barrier to improving outcomes in ALL [5].…”

Section: Pediatric Acute Myeloid Leukemia (Aml) Is the Final Frontiermentioning

confidence: 99%

Pediatric Acute Myeloid Leukemia: Final Frontier for Pediatric Oncologists in Developing World

Yadav

Ramzan

Lall

et al. 2011

Pediatric Hematology and Oncology

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  S. P. Yadav et al. complex cytogenetics in 2, XO in 2, trisomy 8 in 1) disease. In the favorable-risk group, 4 died, 5 were lost to follow-up, and only 1 is alive. Among 5 patients with t(15; 17), only 2 opted for therapy. One died in induction with intracranial bleed and the other relapsed 1 year after finishing therapy. In the intermediate-risk group, 2 died during induction and 2 are alive and disease-free. In the high-risk group, 3 died, 2 were lost to follow-up, and 2 are alive with 1 disease-free.High mortality with intensive protocol, high relapse rates with less intensive protocols, and treatment abandonment are major barriers to improving outcome for pediatric AML in the developing world. Less intensive protocols with better efficacy are the need of the hour. Declaration of interestPediatric Hematology and Oncology

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“…Most centers follow individual protocols and abandonment is censored. Published data on ALL from India have shown survival rates of 40-70% [24,25]. Choice of treatment protocol is important as a recent paper showed that for T cell ALL BFM95 protocol is more effective than UKALLXI protocol [26].…”

Section: Lack Of Cooperative Groups and Multispecialty Carementioning

confidence: 99%

Barriers to Cure for Children with Cancer in India and Strategies to Improve Outcomes: A Report by the Indian Pediatric Hematology Oncology Group

Yadav

Rastogi

Kharya

et al. 2014

Pediatric Hematology and Oncology

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The survival of children with cancer in India is inferior to that of children in high-income countries. The Indian Pediatric Hematology Oncology Group (IPHOG) held a series of online meetings via www.Cure4kids.org to identify barriers to cure and develop strategies to improve outcomes. Five major hurdles were identified: delayed diagnosis, abandonment, sepsis, lack of co-operative groups, and relapse. Development of regional networks like IPHOG has allowed rapid identification of local causes of treatment failure for children with cancer in India and identification of strategies likely to improve care and outcomes in the participating centers. Next steps will include interventions to raise community awareness of childhood cancer, promote early diagnosis and referral, and reduce abandonment and toxic death at each center. Starting of fellowship programs in pediatric hemato-oncology, short training programs for pediatricians, publishing outcome data, formation of parent and patient support groups, choosing the right and effective treatment protocol, and setting up of bone marrow transplant services are some of the effective steps taken in the last decade, which needs to be supported further.

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Survival outcome in childhood acute lymphoblastic leukemia in India

Cited by 8 publications

References 3 publications

Impact of malnutrition on febrile neutropenia in children with acute lymphoblastic leukemia during induction phase chemotherapy

Impact of malnutrition on febrile neutropenia in children with acute lymphoblastic leukemia during induction phase chemotherapy

Pediatric Acute Myeloid Leukemia: Final Frontier for Pediatric Oncologists in Developing World

Barriers to Cure for Children with Cancer in India and Strategies to Improve Outcomes: A Report by the Indian Pediatric Hematology Oncology Group

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