title: Childhood acute lymphoblastic leukaemia: experience from a single tertiary care facility of Pakistan.
abstract: OBJECTIVE
  To evaluate the demographic features, outcome and prognostic factors seen in children with acute lymphoplastic leukaemia at a tertiary care hospital.
  
  
  METHODS
  The retrospective descriptive study was conducted at Aga Khan University Hospital, Karachi, comprising data related to children below 15 years of age and treated between January 1997 and December 2006. Kaplan Meir survival curves were used to describe overall and event-free survival rates. Cox Proportional Hazards model was used to describe factors associated with death and relapse. SPSS 16 was the main statistical tool.
  
  
  RESULTS
  Of the total 121 children diagnosed with the condition, 79 (65.3%) were males; 86 (71.1%) patients were between 1-9 years of age; Immunophenotyping was done in 99 (81.81%) patients: 86 (87%) cases had precursor B and 13 (13.13%) had precursor T. Of the total, 106 (87.6%) patients opted for treatment, while 15 (11.6%) were lost to follow-up. Besides, 26 (21.7%) patients had at least one relapse; the most common site being bone marrow in 13 (50%) followed by central nervous system in 9 (36.6%). There were 20 (16.5%) deaths in the sample. Infection was the most frequent cause of death. The event-free survival and overall survival was 63% (n = 76) and 65% (n = 79) respectively.
  
  
  CONCLUSIONS
  Through the clinical characteristics of children with acute lymphoblastic leukamia were similar to those reported in literature, the outcomes were inferior. The high rate of infections and relapse warrant better supportive care and risk-based approach.
authors.affiliation: Department of Paediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Naureen
authors.initials: N
authors.lastname: Mushtaq
authors.affiliation: Department of Paediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Zehra
authors.initials: Z
authors.lastname: Fadoo
authors.affiliation: Department of Paediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Naqvi
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010154:Pakistan; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D062606:Tertiary Care Centers