Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia
IntroductionThe clarification of etiopathology, the improvement of chemotherapy regimens and their risk stratifications, and the improvement in treatment support have increased the survival of children and adolescents affected by Acute Lymphoblastic Leukemia (ALL) past few years. This study aimed to...
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| Format: | Article |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1223889/full |
| _version_ | 1797690490737393664 |
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| author | Bruno Terra Correa Gabriela Sales Serra Silva Webert Joaquim Silva Mendes Amanda de Moraes Maia Augusto Cezar Magalhães Aleluia Teresa Cristina Cardoso Fonseca Caroline Conceição da Guarda Marilda de Souza Gonçalves Milena Magalhães Aleluia |
| author_facet | Bruno Terra Correa Gabriela Sales Serra Silva Webert Joaquim Silva Mendes Amanda de Moraes Maia Augusto Cezar Magalhães Aleluia Teresa Cristina Cardoso Fonseca Caroline Conceição da Guarda Marilda de Souza Gonçalves Milena Magalhães Aleluia |
| author_sort | Bruno Terra Correa |
| collection | DOAJ |
| description | IntroductionThe clarification of etiopathology, the improvement of chemotherapy regimens and their risk stratifications, and the improvement in treatment support have increased the survival of children and adolescents affected by Acute Lymphoblastic Leukemia (ALL) past few years. This study aimed to estimate overall survival (OS) and event-free survival (EFS) in an onco-hematology treatment center in Brazil, reports the main clinical-laboratory characteristics of patients at diagnosis, verify the frequency of treatment-related adverse effects and the main causes of death.Material and methodsRetrospective analysis involving patients diagnosed with ALL, treated with the protocol of the Brazilian Group for Treatment of Leukemias in Childhood (GBTLI), between 2010 and 2020 was carried out; the outcomes (relapse, deaths, development of new neoplasms) were analyzed SPSS® software was used for the statistical analyses, and the p-value was considered significant when less than 0.05 for all analyses.Results109 patients were included in the study; the median age was 5 years, with a slight predominance of males. Sixty-six patients were classified as high-risk (HR) group and 43 patients were classified as low-risk (LR) group. After 5 years of diagnosis, the OS was 71.5%, and the EFS was 65%. No statistical difference was found between the HR and LR groups for OS and EFS, while leukocyte counts were statistically associated with the outcome of death (p = 0.028). Among the patients, 28 (25.6%) died due to infection accounting 46.4% of death causes. Among the 34 patients with unfavorable outcomes (death and/or relapse), 32 had no research for the minimal residual disease at the end of remission induction, and 25 were not investigated for the presence of chromosomal abnormalities. The most reported complications and treatment-related adverse effects were increased liver transaminases (85.9%), airway infection (79.4%), oral mucositis (67.2%), febrile neutropenia (64.4%), and diarrhea (36.4%).ConclusionsThe rates of OS and EFS obtained in this cohort are similar to those obtained in the few previous similar studies in Brazil and lower than those carried out in developed countries. The unavailability of prognostic tests may have hindered risk stratification and influenced the results obtained. |
| first_indexed | 2024-03-12T02:00:18Z |
| format | Article |
| id | doaj.art-763eedfb6e4049798e2bba925ee49b15 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-12T02:00:18Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pediatrics |
| spelling | doaj.art-763eedfb6e4049798e2bba925ee49b152023-09-07T17:21:31ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-09-011110.3389/fped.2023.12238891223889Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemiaBruno Terra Correa0Gabriela Sales Serra Silva1Webert Joaquim Silva Mendes2Amanda de Moraes Maia3Augusto Cezar Magalhães Aleluia4Teresa Cristina Cardoso Fonseca5Caroline Conceição da Guarda6Marilda de Souza Gonçalves7Milena Magalhães Aleluia8Departamento de Ciências Biológicas, Laboratório de Patologia Aplicada e Genética, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, BrasilDepartamento de Ciências Biológicas, Laboratório de Patologia Aplicada e Genética, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, BrasilDepartamento de Ciências Biológicas, Laboratório de Patologia Aplicada e Genética, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, BrasilDepartamento de Medicina, UNEX, Itabuna, Bahia, BrasilDepartamento de Ciências Naturais, Universidade Estadual do Sudoeste da Bahia-Campus de Vitória da Conquista, Vitória da Conquista, Bahia, BrasilDepartamento de Ciências da Saúde, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, BrasilDepartamento de Ciências Biológicas, Laboratório de Patologia Aplicada e Genética, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, BrasilLaboratório de Investigação Genética e Hematologia Translacional, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Bahia, BrasilDepartamento de Ciências Biológicas, Laboratório de Patologia Aplicada e Genética, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, BrasilIntroductionThe clarification of etiopathology, the improvement of chemotherapy regimens and their risk stratifications, and the improvement in treatment support have increased the survival of children and adolescents affected by Acute Lymphoblastic Leukemia (ALL) past few years. This study aimed to estimate overall survival (OS) and event-free survival (EFS) in an onco-hematology treatment center in Brazil, reports the main clinical-laboratory characteristics of patients at diagnosis, verify the frequency of treatment-related adverse effects and the main causes of death.Material and methodsRetrospective analysis involving patients diagnosed with ALL, treated with the protocol of the Brazilian Group for Treatment of Leukemias in Childhood (GBTLI), between 2010 and 2020 was carried out; the outcomes (relapse, deaths, development of new neoplasms) were analyzed SPSS® software was used for the statistical analyses, and the p-value was considered significant when less than 0.05 for all analyses.Results109 patients were included in the study; the median age was 5 years, with a slight predominance of males. Sixty-six patients were classified as high-risk (HR) group and 43 patients were classified as low-risk (LR) group. After 5 years of diagnosis, the OS was 71.5%, and the EFS was 65%. No statistical difference was found between the HR and LR groups for OS and EFS, while leukocyte counts were statistically associated with the outcome of death (p = 0.028). Among the patients, 28 (25.6%) died due to infection accounting 46.4% of death causes. Among the 34 patients with unfavorable outcomes (death and/or relapse), 32 had no research for the minimal residual disease at the end of remission induction, and 25 were not investigated for the presence of chromosomal abnormalities. The most reported complications and treatment-related adverse effects were increased liver transaminases (85.9%), airway infection (79.4%), oral mucositis (67.2%), febrile neutropenia (64.4%), and diarrhea (36.4%).ConclusionsThe rates of OS and EFS obtained in this cohort are similar to those obtained in the few previous similar studies in Brazil and lower than those carried out in developed countries. The unavailability of prognostic tests may have hindered risk stratification and influenced the results obtained.https://www.frontiersin.org/articles/10.3389/fped.2023.1223889/fullacute lymphoid leukemiasurvivalpediatric canceradverse effectschemotherapy |
| spellingShingle | Bruno Terra Correa Gabriela Sales Serra Silva Webert Joaquim Silva Mendes Amanda de Moraes Maia Augusto Cezar Magalhães Aleluia Teresa Cristina Cardoso Fonseca Caroline Conceição da Guarda Marilda de Souza Gonçalves Milena Magalhães Aleluia Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia Frontiers in Pediatrics acute lymphoid leukemia survival pediatric cancer adverse effects chemotherapy |
| title | Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia |
| title_full | Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia |
| title_fullStr | Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia |
| title_full_unstemmed | Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia |
| title_short | Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia |
| title_sort | association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia |
| topic | acute lymphoid leukemia survival pediatric cancer adverse effects chemotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1223889/full |
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