Survival of childhood acute lymphoblastic leukemia: experience in Chennai.
The object of this study was to evaluate the treatment outcome in children with acute lymphoblastic leukemia (ALL) in Chennai. The problems inherent in a developing country which affect outcome are analyzed. The importance of prognostic factors especially immunotyping is assessed. The period of study was from June 1991 to December 1995. A total of 135 children were studied. Pre B CALLA positive (CD10, CD19, HLA, DR) was the dominant immunotype in 75 children (69 per cent). T-cell ALL was seen in 15 (14 per cent), biphenotype in three (2 per cent), and B in one (0.9 per cent). Seventy children (53 per cent) were treated with a high risk protocol, 25 (17 per cent) received an intermediate risk, and 40 patients (30 per cent) received a standard risk protocol. Analyzing the outcome in 135 children, 34 (27 per cent) had event free survival (EFS) at the time of analysis; of these 41 per cent had EFS after 2 years of therapy, 31 per cent after 3 years and 18.7 per cent after 4 years (i.e. 1 year after stopping 3 years of therapy). Fifty-seven children (41 per cent) dropped out; 25 (18 per cent) died due to sepsis. Treatment obstacles included delay in diagnosis, poor health education and facilities, poor supportive care, and socio-economic problems.
Rajajee
S
S
Department of Hematology, Institute of Child Health and Hospital for Children, Egmore, Chennai, India.
Desikulu
M V
MV
Pushpa
V
V
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000401:mortality*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000401:mortality*; D011379:Prognosis; D018805:Sepsis / Q000401:mortality; D012923:Social Class; D016019:Survival Analysis