Effectiveness of Modified UKALL protocols in Children with Acute  Lymphoblastic Leukemia; an experience of Children Welfare  Teaching Hospital. 

  • Hasanein H. Ghali Department of pediatrics, College of medicine, Baghdad University

Abstract

Background:Acute Lymphoblastic Leukaemia (ALL) is the most common diagnosis  in childhood cancer. Cure is possible and even likely. Aims of study: To evaluate  the effectiveness of modified UKALL protocols in a setting with limited resources  and to define an event free survival of Acute Lymphoblastic Leukemia in children  aged 1 ‐15 years who were committed to finish treatment.  Methods: This is a retrospective study that reviewed 559 children with newly  diagnosed ALL between 1 and 15 years of age during the period: January 1st, 2000  to December 31st, 2009 who were committed to finish treatment protocol. All  patients were treated with regimens modified from Medical Research Council  protocol (United Kingdom Acute Lymphoblastic Leukemia‐ UKALL‐ protocols).  The Event Free Survival (EFS) was measured using Kaplan – Meier method with a  total duration of observation till December 31st 2011 (a minimum of two years post  starting treatment) and data were processed and tabulated using SPSS (Statistical  Package for the Social Sciences) .  Results:The majority of treated children (348, 62.2%) were standard risk group;  remission induction was achieved in 461(82.4%) patients. Eleven patients (1.9%)  were poor responders. Death during first 60 days from treatment was reported in  87 (15.5%) patients and death in complete remission (CR) was reported in 49 (8.7%)  patients. The major presumptive causes of death were infection/sepsis followed  by bleeding. Of 559 patients; 302(54%) remained in continuous complete remission  with a median follow up time of 52.5 months (range from 23.9 months‐ 11.6 years).  There was a significant difference in EFS between Standard Risk group (61.2%) and  High Risk group (42.2%) after induction (P=0.02) and in later phases of therapy  (P=0.0002). Increased relapse rate in high risk group was the reason behind the  difference in EFS (P=0.0004) between two groups. Relapses were documented in  110(19.6%) patients and the bone marrow (51.8%) was the main site of relapse  followed by CNS (27.2%).  Conclusion:The study showed lower ALL EFS than that of recognized cancer  centers. 

Published
2018-06-09
How to Cite
GHALI, Hasanein H.. Effectiveness of Modified UKALL protocols in Children with Acute  Lymphoblastic Leukemia; an experience of Children Welfare  Teaching Hospital. . Mustansiriya Medical Journal, [S.l.], v. 13, n. 2, p. 8, june 2018. ISSN 2227-4081. Available at: <http://mmj.uomustansiriyah.edu.iq/index.php/MMJ/article/view/216>. Date accessed: 10 apr. 2020.