Clinicolaboratory Characteristics and Outcome of Pediatric Acute Lymphoblastic Leukemia in a Resource-Limited Setting: A Study from South Egypt
Background: Remarkable progress has been made in the treatment of pediatric acute lymphoblastic leukemia (ALL), with survival rates reaching > 80% in high-income countries. In Egypt, the outcome of treatment of ALL has been less favorable. Aim: To evaluate the clinicolaboratory characteristics i...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine
2022-12-01
|
| Series: | Research in Oncology |
| Subjects: | |
| Online Access: | https://resoncol.journals.ekb.eg/article_254268_0720d9230af7730c21c3b0daa25fda84.pdf |
| _version_ | 1797977739658002432 |
|---|---|
| author | Amany Ali Amira El-Hefedy Douaa Sayed Amira Osman |
| author_facet | Amany Ali Amira El-Hefedy Douaa Sayed Amira Osman |
| author_sort | Amany Ali |
| collection | DOAJ |
| description | Background: Remarkable progress has been made in the treatment of pediatric acute lymphoblastic leukemia (ALL), with survival rates reaching > 80% in high-income countries. In Egypt, the outcome of treatment of ALL has been less favorable. Aim: To evaluate the clinicolaboratory characteristics in patients admitted at Sohag Cancer Center and to assess the outcome and the prognostic factors affecting it. Methods: This retrospective study included 79 pediatric ALL patients, from January 2010 to December 2014, who were treated according to modified Total therapy study XIIIB high-risk ALL of St. Jude Children's Research Hospital (SJCRH). Results: 52% were males with a median age of 6 years. 58.2% were stratified as HR, 69.6% had precursor B-ALL, 39.2% presented with total leucocytic count (TLC) (≥ 50x109/L), and 11.3% had CNS leukemia. Complete remission (CR) was achieved in 87.3%. Regarding treatment outcome, induction failure was reported in 5.1%, relapse in 24.1%, deaths in CR in 7.2%, and continuous complete remission in 59.5%. The median follow-up was 42 months, 4 years OS, EFS, and DFS were 64.1 ± 5.6, 57 ± 5.7, and 63.3 ± 5.8% respectively. TLC and bone marrow aspirate postinduction were the only significant prognostic factors affecting EFS. Conclusions: The modified TXIIIB of SJCRH was effective in improving ALL outcomes in our center, however, survival rates were much lower than internationally reported results with only initial TLC and response postinduction having a significant effect on EFS and DFS. |
| first_indexed | 2024-04-11T05:12:54Z |
| format | Article |
| id | doaj.art-50af3b24ea604c0e911386563b9989ec |
| institution | Directory Open Access Journal |
| issn | 2357-0687 2357-0695 |
| language | English |
| last_indexed | 2024-04-11T05:12:54Z |
| publishDate | 2022-12-01 |
| publisher | Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine |
| record_format | Article |
| series | Research in Oncology |
| spelling | doaj.art-50af3b24ea604c0e911386563b9989ec2022-12-24T20:13:50ZengKasr Al-Ainy Center of Clinical Oncology and Nuclear MedicineResearch in Oncology2357-06872357-06952022-12-01182616810.21608/resoncol.2021.82375.1147254268Clinicolaboratory Characteristics and Outcome of Pediatric Acute Lymphoblastic Leukemia in a Resource-Limited Setting: A Study from South EgyptAmany Ali0Amira El-Hefedy1Douaa Sayed2Amira Osman3Department of Pediatric Oncology and Hematological Malignancies, South Egypt Cancer Institute, Assiut University, Assiut, EgyptDepartment of Pediatric Oncology, Sohag Cancer Center, Sohag, EgyptDepartment of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, EgyptDepartment of Pediatric Oncology and Hematological Malignancies, South Egypt Cancer Institute, Assiut University, Assiut, EgyptBackground: Remarkable progress has been made in the treatment of pediatric acute lymphoblastic leukemia (ALL), with survival rates reaching > 80% in high-income countries. In Egypt, the outcome of treatment of ALL has been less favorable. Aim: To evaluate the clinicolaboratory characteristics in patients admitted at Sohag Cancer Center and to assess the outcome and the prognostic factors affecting it. Methods: This retrospective study included 79 pediatric ALL patients, from January 2010 to December 2014, who were treated according to modified Total therapy study XIIIB high-risk ALL of St. Jude Children's Research Hospital (SJCRH). Results: 52% were males with a median age of 6 years. 58.2% were stratified as HR, 69.6% had precursor B-ALL, 39.2% presented with total leucocytic count (TLC) (≥ 50x109/L), and 11.3% had CNS leukemia. Complete remission (CR) was achieved in 87.3%. Regarding treatment outcome, induction failure was reported in 5.1%, relapse in 24.1%, deaths in CR in 7.2%, and continuous complete remission in 59.5%. The median follow-up was 42 months, 4 years OS, EFS, and DFS were 64.1 ± 5.6, 57 ± 5.7, and 63.3 ± 5.8% respectively. TLC and bone marrow aspirate postinduction were the only significant prognostic factors affecting EFS. Conclusions: The modified TXIIIB of SJCRH was effective in improving ALL outcomes in our center, however, survival rates were much lower than internationally reported results with only initial TLC and response postinduction having a significant effect on EFS and DFS.https://resoncol.journals.ekb.eg/article_254268_0720d9230af7730c21c3b0daa25fda84.pdfacute lymphoblastic leukemiaegyptlimited resourcespediatricoutcome |
| spellingShingle | Amany Ali Amira El-Hefedy Douaa Sayed Amira Osman Clinicolaboratory Characteristics and Outcome of Pediatric Acute Lymphoblastic Leukemia in a Resource-Limited Setting: A Study from South Egypt Research in Oncology acute lymphoblastic leukemia egypt limited resources pediatric outcome |
| title | Clinicolaboratory Characteristics and Outcome of Pediatric Acute Lymphoblastic Leukemia in a Resource-Limited Setting: A Study from South Egypt |
| title_full | Clinicolaboratory Characteristics and Outcome of Pediatric Acute Lymphoblastic Leukemia in a Resource-Limited Setting: A Study from South Egypt |
| title_fullStr | Clinicolaboratory Characteristics and Outcome of Pediatric Acute Lymphoblastic Leukemia in a Resource-Limited Setting: A Study from South Egypt |
| title_full_unstemmed | Clinicolaboratory Characteristics and Outcome of Pediatric Acute Lymphoblastic Leukemia in a Resource-Limited Setting: A Study from South Egypt |
| title_short | Clinicolaboratory Characteristics and Outcome of Pediatric Acute Lymphoblastic Leukemia in a Resource-Limited Setting: A Study from South Egypt |
| title_sort | clinicolaboratory characteristics and outcome of pediatric acute lymphoblastic leukemia in a resource limited setting a study from south egypt |
| topic | acute lymphoblastic leukemia egypt limited resources pediatric outcome |
| url | https://resoncol.journals.ekb.eg/article_254268_0720d9230af7730c21c3b0daa25fda84.pdf |
| work_keys_str_mv | AT amanyali clinicolaboratorycharacteristicsandoutcomeofpediatricacutelymphoblasticleukemiainaresourcelimitedsettingastudyfromsouthegypt AT amiraelhefedy clinicolaboratorycharacteristicsandoutcomeofpediatricacutelymphoblasticleukemiainaresourcelimitedsettingastudyfromsouthegypt AT douaasayed clinicolaboratorycharacteristicsandoutcomeofpediatricacutelymphoblasticleukemiainaresourcelimitedsettingastudyfromsouthegypt AT amiraosman clinicolaboratorycharacteristicsandoutcomeofpediatricacutelymphoblasticleukemiainaresourcelimitedsettingastudyfromsouthegypt |