title: Outcome of modified St Jude total therapy 13A for childhood acute lymphoblastic leukemia in the southeast region of Turkey.
abstract: OBJECTIVE
  To fill the gap in the current data on childhood acute lymphoblastic leukemia (ALL) in low-income and middle-income countries.
  
  
  METHODS
  This study included 106 children between the ages of 1 and 17 years with newly diagnosed ALL monitored between 1999 and 2010. All the patients were treated with the modified St Jude Total 13A treatment plan at the Pediatric Hematology Clinic at Harran University.
  
  
  RESULTS
  Sixty-eight (64.2%) patients were boys and 38 (35.8%) were girls. The median age at diagnosis was 5.9 ± 3.7 years. Thirty-eight (35.8%) children were classified as standard risk, 53 (39.3%) were intermediate risk, and 15 (14.2%) were high risk. Thirteen (12.3%) children died in induction before the remission date (43 d of remission induction). Of all the 93 (100%) patients who completed remission induction therapy and whose bone marrow were in remission, 5 (4.7%) had a bone marrow relapse, 1 (0.9%) had a retinal relapse, and 5 (4.7%) had secondary acute myeloid leukemia. At a median follow-up of 44 months (range, 0.36 to 135.5 mo), the estimated 5-year overall survival and event-free survival were 77.4 ± 5% and 68.9 ± 6.5%, respectively. The estimated 5-year overall survival for boys and girls was 76.5 ± 6% and 65.8 ± 8%, respectively (P = 0.182).
  
  
  CONCLUSIONS
  St Jude Total 13A treatment protocols to treat childhood ALL can be successfully adapted, which suggests that such an approach may be useful in low socioeconomic regions; however, it should be noted that secondary leukemia can occur at a high rate.
authors.affiliation: Pediatric Hematology Department, Medical Faculty, Harran University, Sanliurfa, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Koc
authors.forename: Ali
authors.initials: A
authors.lastname: Aycicek
authors.forename: Zeynep C
authors.initials: ZC
authors.lastname: Ozdemir
authors.forename: Murat
authors.initials: M
authors.lastname: Soker
authors.forename: Mustafa
authors.initials: M
authors.lastname: Varma
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000401:mortality*; D012074:Remission Induction; D015996:Survival Rate; D016896:Treatment Outcome; D014421:Turkey