Outcome of childhood acute Lymphoblastic leukemia in Egyptian children: a challenge for limited health resource countries

Autor:	Maha M. El-Gaafary, Azza A.G. Tantawy, Farida H. El-Rashidy, Iman A. Ragab, Osama A. Ramadan
Rok vydání:	2013
Předmět:	Male Pediatrics medicine.medical_specialty Adolescent Disease-Free Survival Risk groups Standard Risk Risk Factors Antineoplastic Combined Chemotherapy Protocols medicine Humans Central nervous system leukemia Prospective Studies Child Childhood all Childhood Acute Lymphoblastic Leukemia business.industry Infant Mean age Hematology Health resource Precursor Cell Lymphoblastic Leukemia-Lymphoma University hospital Survival Rate Treatment Outcome Child Preschool Health Resources Egypt Female business Follow-Up Studies
Zdroj:	Hematology (Amsterdam, Netherlands). 18(4)
ISSN:	1607-8454
Popis:	In childhood acute lymphoblastic leukemia (ALL) the reported 5-year event-free survival (EFS) rates are as high as 80%. Since 2004, multiple Egyptian centers shifted protocol of therapy of ALL to the CCG 1991 (the single delayed intensification arm) and CCG 1961 protocol for standard risk and high-risk ALL therapy, respectively, being cost effective. We aimed to evaluate the efficacy and safety of the CCG protocol in treatment of childhood ALL in Ain Shams and Menoufeya University hospitals.Fifty-two ALL patients, aged 1-17 years, treated according to the modified CCG protocol in both centers and registered from November 2004 to December 2005 were included. They were classified into three risk groups, standard risk (SR), high-risk standard arm (HR-SA), and high-risk augmented arm (HR-AA).The mean age at diagnosis was 5.9 + 3.3 years, male/female ratio of 1.6:1, and central nervous system leukemia represented 6%. The 5-year overall survival (OS) and EFS were 84.6% and 67%, respectively. The 5-year OS and EFS were 92.6% and 70% in SR, 68.8% and 55% in HR-SA, 88.9% and 80% in HR-AA patients, respectively. Six patients had grade 3-4 adverse events.The outcome of HR-SA protocol was inferior to the other two groups, necessitating shift to a more intensified arm with double delayed intensification. The use of minimal residual disease for better risk classification of childhood ALL is recommended in our centers.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1b3fc85e393705a2507315728e917311 https://pubmed.ncbi.nlm.nih.gov/23394310 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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