title: Childhood acute lymphoblastic leukemia in the Middle East and neighboring countries: a prospective multi-institutional international collaborative study (CALLME1) by the Middle East Childhood Cancer Alliance (MECCA).
abstract: BACKGROUND
  Little is known about childhood ALL in the Middle East. This study was undertaken by MECCA as initial efforts in collaborative data collection to provide clinical and demographic information on children with ALL in the Middle East.
  
  
  METHODS
  Clinical and laboratory data for patients with ALL between January 2008 and April 2012 were prospectively collected from institutions in 14 Middle East countries and entered into a custom-built-database during induction phase. All laboratory studies including cytogenetics were done at local institutions.
  
  
  RESULTS
  The 1,171 voluntarily enrolled patients had a mean age of 6.1 ± 3.9 years and 59.2% were boys. T-ALL represented 14.8% and 84.2% had B-precursor ALL. At diagnosis, 5.6% had CNS disease. The distribution of common genetic abnormalities reflected a similar percentage of hyperdiploidy (25.6%), but a lower percentage of ETV6-RUNX1 translocation (14.7%) compared to large series reported from Western populations. By clinical criteria, 47.1% were low/standard risk, 16.9% were intermediate risk, and 36% were high risk. Most patients received all their care at the same unit (96.9%). Patients had excellent induction response to chemotherapy with an overall complete remission rate of 96%. Induction toxicities were acceptable.
  
  
  CONCLUSIONS
  This first collaborative study has established a process for prospective data collection and future multinational collaborative research in the Middle East. Despite the limitations of an incomplete population-based study, it provides the first comprehensive baseline data on clinical characteristics, laboratory evaluation, induction outcome, and toxicity. Further work is planned to uncover possible biologic differences of ALL in the region and to improve diagnosis and management.
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology, Doha, Qatar.
authors.forename: Naima A
authors.initials: NA
authors.lastname: Al-Mulla
authors.forename: Prem
authors.initials: P
authors.lastname: Chandra
authors.forename: Mohammed
authors.initials: M
authors.lastname: Khattab
authors.forename: Faris
authors.initials: F
authors.lastname: Madanat
authors.forename: Parvaneh
authors.initials: P
authors.lastname: Vossough
authors.forename: Eyad
authors.initials: E
authors.lastname: Torfa
authors.forename: Zakiya
authors.initials: Z
authors.lastname: Al-Lamki
authors.forename: Gamal
authors.initials: G
authors.lastname: Zain
authors.forename: Samar
authors.initials: S
authors.lastname: Muwakkit
authors.forename: Salah
authors.initials: S
authors.lastname: Mahmoud
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Al-Jassmi
authors.forename: Murat
authors.initials: M
authors.lastname: Tuncer
authors.forename: Hussein
authors.initials: H
authors.lastname: Al-Mukharraq
authors.forename: Sihem
authors.initials: S
authors.lastname: Barsaoui
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Arceci
authors.forename: Scott C
authors.initials: SC
authors.lastname: Howard
authors.forename: Andreas E
authors.initials: AE
authors.lastname: Kulozik
authors.forename: Yaddanapudi
authors.initials: Y
authors.lastname: Ravindranath
authors.forename: Gregory H
authors.initials: GH
authors.lastname: Reaman
authors.forename: Mohammad
authors.initials: M
authors.lastname: Farranoush
authors.forename: Abdullah A
authors.initials: AA
authors.lastname: AlNasser
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D050676:Core Binding Factor Alpha 2 Subunit / Q000235:genetics; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008877:Middle East / Q000453:epidemiology; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D015996:Survival Rate; D014178:Translocation, Genetic; D000097764:ETS Translocation Variant 6 Protein
chemical_list: D050676:Core Binding Factor Alpha 2 Subunit; D015514:Oncogene Proteins, Fusion; C102421:TEL-AML1 fusion protein; D000097764:ETS Translocation Variant 6 Protein
keywords: MECCA; induction; leukemia; pediatric