Prednisolone Prophase for a Week Versus Upfront Multiagent Chemotherapy in Childhood Acute Lymphoblastic Leukemia: An Analysis With Reference to Induction Mortality in a Developing Country
| Autor: | Naeem Jabbar, Neelum Mansoor, Zainab Butt, Kishwer Nadeem, Shamvil Ashraf, Sidra Maqsood |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Antineoplastic Agents Hormonal medicine.medical_treatment Prednisolone Disease Disease-Free Survival Sepsis 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Child Childhood Acute Lymphoblastic Leukemia Developing Countries Disease burden Retrospective Studies Chemotherapy business.industry Remission Induction Infant Retrospective cohort study Hematology Induction Chemotherapy Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Oncology 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Cohort Female business 030215 immunology medicine.drug |
| Zdroj: | Journal of pediatric hematology/oncology. 42(3) |
| ISSN: | 1536-3678 |
| Popis: | In childhood acute lymphoblastic leukemia, high treatment-related mortality, especially in the induction phase of treatment, is a major challenge for developing countries. The reasons are multifactorial, including a late presentation with higher disease burden, malnourishment, and limited support services. These factors may aggravate the toxic effects of upfront multiagent chemotherapy in terms of severe neutropenic sepsis and tumor lysis. Therefore, instead of upfront chemotherapy, we offered prednisolone prophase for 1 week with the objective of balancing the antileukemic versus the toxic effect of treatment. The data of 538 patients who received induction with this approach (cohort B) are compared for induction mortality with previous records of 438 patients (cohort A) treated with upfront chemotherapy. In the presence of similar clinical characteristics including age, sex, risk group, and phenotype in both cohorts, a significant difference was found in overall induction mortality of 9% in cohort B versus 14% in cohort A (P |
| Databáze: | OpenAIRE |
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