Poorer outcome of childhood acute lymphoblastic leukemia in the Bedouin population: A report from the Berlin-Frankfurt-Muenster-based Israeli national protocols.

Autor: Elhasid R; Department of Pediatric Hemato-Oncology, Tel Aviv Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Nirel R; Department of Statistics, Hebrew University, Jerusalem, Israel., Avigad S; Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Avrahami G; Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Abramov A; Department of Pediatric Hematology/Oncology, Shaare Zedek Medical Center, Jerusalem, Israel., Attias D; Department of Pediatric Hematology/Oncology, Bnei-Zion Medical Center and Faculty of Medicine, Technion, Haifa, Israel., Arad N; Department of Pediatric Hematology/Oncology, Rambam Medical Center, and The Bruce Rappaport Faculty of Medicine, Technion-Israel, Institute of Technology, Haifa, Israel., Ballin A; Department of Pediatric Hematology/Oncology, Edith Wolfson Medical Center, Holon, Israel., Ben-Arush M; Department of Pediatric Hematology/Oncology, Rambam Medical Center, and The Bruce Rappaport Faculty of Medicine, Technion-Israel, Institute of Technology, Haifa, Israel., Bielorai B; Department of Pediatric Hematology/Oncology Chaim Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Burstein Y; Department of Pediatric Hemato-Oncology, Tel Aviv Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Elitzur S; Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Gabriel H; Department of Pediatric Hematology/Oncology, Ha-Emek Medical Center, Afula, Israel., Hameiri-Grossman M; Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Kapelushnik J; Department of Pediatric Hematology/Oncology, Soroka Medical Center, Beer Sheva, Israel., Sthoeger D; Department of Pediatric Hematology/Oncology, Kaplan Medical Center, Rehovot, Israel., Toren A; Department of Pediatric Hematology/Oncology Chaim Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Wientraub M; Department of Pediatric Hematology/Oncology, Hadassah University Hospital, Hebrew University Hadassah Medical School, Jerusalem, Israel., Yaniv I; Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Izraeli S; Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Stark B; Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2020 Jan; Vol. 67 (1), pp. e28024. Date of Electronic Publication: 2019 Oct 08.
DOI: 10.1002/pbc.28024
Abstrakt: Background: Therapy outcomes for childhood acute lymphoblastic leukemia (ALL) had substantially improved in the last decades, but variability across racial and ethnic groups was identified in some clinical studies. In this study, we aimed to investigate whether such a difference in outcome is found in the diverse ethnicities in Israel as well.
Methods: A retrospective study was conducted among 1154 patients (855 Jews, 195 Muslims, 52 Bedouins, 26 Druze, and 26 others) aged 1 to 21 years, who were diagnosed with ALL between 1989 and 2011 and were treated according to the same Berlin-Frankfurt-Muenster-based Israel National Study protocols.
Results: Bedouins had a higher incidence of t(1;19) (16% vs 3% for non-Bedouins) and a lower incidence of high-hyperdiploidy (10% vs 25% for non-Bedouins) (P = 0.01). Five-year event-free survival (EFS) and overall survival (OS) were poorer for the Bedouins (60.3% ± 7.2% and 63.1% ± 7.2%, respectively) compared with the Jews, Muslims, and Druze (80.4% ± 1.4%, 77.3% ± 3.2%, and 84% ± 7.3%, respectively, for EFS [P = 0.02], and 86.3% ± 1.2%, 82.3% ± 2.9%, and 88.3% ± 6.4%, respectively, for OS [P = 0.002]). Adherence to intensive chemotherapy was similar between the Muslims and the Bedouins.
Conclusions: Our findings suggest that the Bedouins, a highly inbred ethnic Arab people, may be considered a higher risk group that may need more intensive chemotherapy and/or supportive care in order to improve their outcome.
(© 2019 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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