TREATMENT RESPONSE EVALUATION OF THE INDUCTION CHEMOTHERAPY IN CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA
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Abstract
Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children and represents 75–80% of acute leukemia in this age group. The likelihood of long-term cure in ALL depends on the clinical and laboratory features and the treatment received. The initial response to the induction chemotherapy is one of the most important prognostic marker & future guide to the management options.
Aims & Objectives: To assess response of the induction chemotherapy in children with acute lymphoblastic leukemia.
Patients & Methods: We have retrospectively evaluated the 101 diagnosed cases of acute lymphoblastic leukemia treated in our hospital from 2013 to 2016 and analyzed the response of standard induction chemotherapy (MRCALL97) after 28 day by bone marrow biopsy.
Results: Out of 101, 16 (15.85%) patients died due to infective and hemorrhagic complications and could not complete the induction therapy. Out of 85, there were 52 (61.2%) male & 33 (32.8%) female patients. Mean age of the patients was 10.16. ± 4.87 years and the age ranges between 01-18 years. Mean white blood cell (WBC) counts & the mean blast cell percent at diagnoses was 39.2 + 60.88/microlitre and 71.7 + 21.2% respectively. 63 (74.1%) patients have blast cells above 50% & 22 (25.9%) patients with blast cells below 50% noted. 9 (10.6%) patient’s shows CNS involvement at initial workup. Post chemotherapy bone marrow biopsy on day 28 shows complete remission (CR) in 65 (76.47%) patients including 42(64.6%) male and 23 (35.4%) female. induction failure occurred in 20 (23.5%) patients including 10 (50%) male and 10 (50%) female. All 9 patients with CNS involvement at presentation could not achieve complete remission.
Conclusions: This study contributes to a better understanding of the factors influencing induction chemotherapy outcomes and highlights areas for future research and clinical practice improvements.
References
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Zubair Ali Memon
Assistant Consultant Adult Oncology King Faisal Specialist Hospital & Research Centre Jeddah, Saudi Arabia
Jawad Ali Memon
Associate Professor Diagnostic Radiology Peoples University of Medical & Health Sciences for Women PUMHSW.SBA
Mohammad Sibtain Shah
Assistant Professor Oncology Peoples University of Medical & Health Sciences for Women PUMHSW.SBA
Mohammad Saleh Chandio
Senior Registrar Oncology Gambat Institute of Medical Sciences (GIMS) Gambat
Ameeran Baloch
Consultant Clinical Oncologist Nuclear Institute of Medicine & Radiotherapy (NIMRA) Jamshoro