title: Childhood T-lineage acute lymphoblastic leukemia: management and outcome at a tertiary care center in North India.
abstract: OBJECTIVE
  To assess the clinical features, prognostic factors and outcome of childhood T-ALL in comparison with B-lineage ALL, treated with a uniform treatment regimen (MCP 841).
  
  
  METHODS
  Pediatric oncology division of a tertiary care institution in Northern India.
  
  
  METHODS
  Retrospective analysis of clinical data and survival outcome.
  
  
  METHODS
  60 children with T-ALL and 139 with B- lineage ALL, and less than 15 years of age treated over 15 years.
  
  
  RESULTS
  T-ALL was observed in 30%. High risk features at presentation (age >10 years, WBC >50,000/mm3, mediastinal mass, and CNS leukemia) were significantly more frequent in T-ALL as compared to B-lineage ALL (P=0.049, P<0.001, P<0.001 and P=0.02, respectively).  Fifty five of 60 T-ALL patients (91.7%) achieved complete remission after induction therapy.  There were 3 induction and 10 remission deaths while 11 (18.3%) relapsed. The overall survival and event-free survival of T-lineage ALL (61.5±7.6 and 49.9±7.4, respectively) were similar to that of B-lineage patients (68.7±4.7 and 47.1±5.1, respectively). National Cancer Institute risk groups emerged as significant prognostic factor for event free survival only in B-lineage patients.
  
  
  CONCLUSIONS
  Even though high risk features were significantly more frequent in T-ALL, survival outcome was similar to that of B-lineage patients. None of the routinely described prognostic parameters significantly impacted survival.
authors.affiliation: Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India. lsarya@rediffmail.com
authors.forename: L S
authors.initials: LS
authors.lastname: Arya
authors.forename: K S
authors.initials: KS
authors.lastname: Padmanjali
authors.forename: S
authors.initials: S
authors.lastname: Sazawal
authors.forename: R
authors.initials: R
authors.lastname: Saxena
authors.forename: M
authors.initials: M
authors.lastname: Bhargava
authors.forename: K P
authors.initials: KP
authors.lastname: Kulkarni
authors.forename: M
authors.initials: M
authors.lastname: Adde
authors.forename: I
authors.initials: I
authors.lastname: Magrath
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000628:therapy*; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000628:therapy*; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome