Premium
Treatment of children with acute lymphoblastic leukemia in India using a BFM protocol
Author(s) -
Bajel Ashish,
George Biju,
Mathews Vikram,
Viswabandya Auro,
Kavitha M.L.,
Srivastava Alok,
Chandy Mammen
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21671
Subject(s) - medicine , prednisolone , complete remission , lymphoblastic leukemia , cohort , blood cancer , pediatrics , surgery , leukemia , gastroenterology , chemotherapy , cancer
Background Limited data exists on the long‐term treatment outcome and prognosis of childhood ALL in India. Procedure Three hundred and seven children (1–14 years) with acute lymphoblastic leukemia (ALL) were treated with a modified BFM protocol 76/79 between 1985 and 2003. Treatment outcome and prognostic factors were evaluated. Results The median age was 6 years; 78% had B lineage acute lymphoblastic leukemia and 22% had T lineage disease. Good prednisolone response was observed in 82% of cases. Two hundred and seventy‐three children (91.6%) achieved complete remission; with 2% induction‐related mortality and 6.4% having resistant disease. 52% of all evaluable patients and 56.8% of complete responders are in continuous complete remission (CCR) at a median follow up of 62 months (30–194 months). The median event free survival (EFS) was 114 months. The estimated 5 year overall survival, EFS and disease free survival was 59.8%, 56%, and 53.9%, respectively. The prognostic factors adversely affecting the EFS were poor prednisolone response, resistant disease and WBC count greater than 20 × 10 9 /L at diagnosis. The 5 year EFS in the favorable risk group (age 1–9 years, WBC count less than 20 × 10 9 /L and prednisolone good response) was 73.1 ± 4.9%. Conclusion This report examines a cohort of children with ALL treated with a BFM protocol in India with adequate follow up and demonstrates the need for cost effective improvements. Pediatr Blood Cancer 2008;51:621–625. © 2008 Wiley‐Liss, Inc.