title: Outcome of childhood acute lymphoblastic leukemia in Jordan.
abstract: BACKGROUND
  Accurate data about childhood acute lymphoblastic leukemia (ALL) in low- and middle-income countries are lacking. Our study is designed to assess survival of childhood ALL at King Hussein Cancer Center (KHCC) using modified St. Jude Children's Research Hospital protocols.
  
  
  METHODS
  We reviewed the medical records of children 1-18 years of age who were diagnosed with ALL and treated at KHCC from January 2003 through December 2009. Disease characteristics and outcome were analyzed.
  
  
  RESULTS
  Over a 7-year period, 300 children with ALL were treated. One hundred and seventy-three (57.7%) were males and 127 (42.3%) were females. The median age at diagnosis was 5 years. One hundred and fifty-seven (52.3%) children were classified as low-risk, 118 (39.3%) were standard-risk and 25 (8.3%) were high-risk. Two hundred and sixty-two (88.5%) children had pre-B cell phenotype and 34 (11.5%) had T-cell phenotype. Two hundred and seventy-three (91.3%) children were classified as having CNS I disease, 24 (8%) had CNS II, and 2 (0.67%) had CNS III. Cytogenetic abnormalities included: t(12;21) in 30 (12%) children and t(9;22) in 18 (7.4%). Four (1.3%) children died in induction, 6 (2%) died in first remission and 27 (9%) relapsed. After a median follow-up of 34.5 months (range 0.32-84.5), the estimated 5-year event free survival and overall survival were 80% and 89%, respectively.
  
  
  CONCLUSIONS
  Treatment protocols developed by major cooperative groups and institutions to treat childhood ALL was successfully adapted and suggest that such an approach may be useful in other low- and middle-income countries.
authors.affiliation: Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan.
authors.forename: Hadeel
authors.initials: H
authors.lastname: Halalsheh
authors.forename: Najyah
authors.initials: N
authors.lastname: Abuirmeileh
authors.forename: Rawad
authors.initials: R
authors.lastname: Rihani
authors.forename: Faiha
authors.initials: F
authors.lastname: Bazzeh
authors.forename: Luna
authors.initials: L
authors.lastname: Zaru
authors.forename: Faris
authors.initials: F
authors.lastname: Madanat
mesh_terms: D000293:Adolescent; D016543:Central Nervous System Neoplasms; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007597:Jordan; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome