title: Comparison of long-term outcome between white and Vietnamese children treated for acute lymphoblastic leukemia according to the FRALLE 2000 protocol.
abstract: OBJECTIVE
  To compare the relapse-free survival (RFS) in Vietnamese (n=141) and white (n=94) children living in Vietnam and Belgium, respectively, and treated in their own country for acute lymphoblastic leukemia according to the same FRALLE 2000 protocol.
  
  
  RESULTS
  RFS was significantly worse in Vietnamese children (hazards ratio=4.48; 95% confidence interval [CI], 2.16-9.3; P<0.01). The 5-year RFS was 83.8% (95% CI, 76.3%-92.0%) and 47.8% (95% CI, 35.6%-64.2%) for white and Vietnamese children, respectively. In the latter group, relapses occurred in bone marrow and cerebrospinal fluid at a much earlier stage. The outcome was compared at first relapse only because of different treatments afterward, according to the country. Both series were similar for sex, age at diagnosis, initial white blood cell count, cytogenetic abnormalities, and corticosensitivity at day 8. Higher frequency of L2-acute lymphoblastic leukemia (P<0.001) but lower frequency of T-acute lymphoblastic leukemia (P=0.004) were observed in Vietnamese children.
  
  
  CONCLUSIONS
  Several factors may contribute to the poor RFS in Vietnamese children, which include the time interval before the first intrathecal therapy and differences in the management of drug-related toxicity. However, additional contribution of socioeconomic factors and/or variations in pharmacogenetic polymorphisms in Vietnamese patients cannot currently be ruled out.
authors: *Department of Pediatric Hematology and Oncology, Cliniques universitaires Saint-Luc †Centre de Technologies Moléculaires Appliquées (CTMA) ∥Epidemiology and Biostatistics Department, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCL) ¶Defence Laboratories Department, Belgian Armed Forces, Brussels, Belgium ‡Pham Ngoc Thach University of Medecin §Blood Transfusion and Hematology Hospital, Ho Chi Minh City, Vietnam.
authors: Phuong Thu
authors: PT
authors: Vu Hoang
authors: Jérôme
authors: J
authors: Ambroise
authors: Vu Luan
authors: VL
authors: Dang Chi
authors: Anne-France
authors: AF
authors: Dekairelle
authors: Sophie
authors: S
authors: Dupont
authors: Nghia
authors: N
authors: Huynh
authors: Tan Binh
authors: TB
authors: Nguyen
authors: Annie
authors: A
authors: Robert
authors: Jean-Luc
authors: JL
authors: Gala
authors: Christiane
authors: C
authors: Vermylen
mesh_terms: D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D044466:Asian People / Q000706:statistics & numerical data*; D001530:Belgium / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D015122:Mercaptopurine / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000208:ethnology / Q000401:mortality; D016016:Proportional Hazards Models; D016896:Treatment Outcome; D014744:Vietnam / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000964:Antimetabolites, Antineoplastic; D015122:Mercaptopurine; D008727:Methotrexate