Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Relapse-free Rate with Childhood Acute Lymphoblastic Leukemia Treated under the Thai National Protocol

  • Tharnprisan, Piangjit (Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University) ;
  • Khiewyoo, Jiraporn (Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University) ;
  • Sripraya, Piporn (Department of Pediatrics, Faculty of Medicine, Khon Kaen University) ;
  • Wiangnon, Surapon (Department of Pediatrics, Faculty of Medicine, Khon Kaen University)
  • Published : 2013.02.28
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Abstract

Background: The standard national protocol for treatment of acute lymphoblastic leukemia (ALL) in children was implemented in 2006. A systematic evaluation of the treatment outcome is needed. This study examined the relapse-free survival among childhood ALL cases treated with this protocol and related factors. Materials and Methods: A descriptive study was conducted in children aged between 0-15 years, newly diagnosed with ALL between March 2006 and March 2011 at Srinagarind Hospital, Department of Pediatrics, Faculty of Medicine, Khon Kaen University. The patients were treated on the basis of stratified risk as per the Thai national protocol. Data were compiled from the hospital records. The Kaplan-Meier method was used to describe relapse-free survival and the Cox proportional hazard model to investigate the associated factors. Results: Of the 103 children recruited, 86 (83.5%) achieved complete remission. The total follow-up time was 3132.5 person-months. Eighteen (20.9%) relapsed. The incidence density was 0.6 per 100 person-months (95%CI: 0.4, 0.9). The respective relapse-free rates at 1, 3 and 5 years were 93.0% (95%CI: 85.1, 96.8), 84.5% (95%CI: 74.0, 90.9) and 64.1% (95%CI: 45.6, 77.8). A factor associated with the relapse-free rate was age under 1 year (HR=6.0; 95%CI: 1.1, 33.8). Conclusions: The rate of being relapse-free in ALL children treated under the Thai national protocol at Srinagarind Hospital was better than with former protocols; however, it is still not as good as in developed countries. Further review of the treatment approach of ALL is needed.

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References

  1. Bajel A, George B, Mathews V, et al (2008). Treatment of children with acute lymphoblastic leukemia in India using a BFM protocol. Pediatr Blood Cancer, 51, 621-5. https://doi.org/10.1002/pbc.21671
  2. Chainansamit S (2001). Childhood acute lymphoblastic leukemia in Khon Kaen Regional Hospital. Khon Kaen Med J, 25, 11-25.
  3. Gupta S, Antillon FA, Bonilla M, et al (2011). Treatment-related mortality in children with acute lymphoblastic leukemia in Central America. Cancer , 117, 4788-95. https://doi.org/10.1002/cncr.26107
  4. Hazar V, Karasu GT, Uygun V, et al (2010). Childhood acute lymphoblastic leukemia in Turkey: factors influencing treatment and outcome: a single center experience. J Pediatr Hematol Oncol, 32, 317-22. https://doi.org/10.1097/MPH.0b013e3181ced271
  5. Kamsa-ard S, Wiangnon S, Kamsa-ard S, et al (2006). Trends in Incidence of childhood leukemia, Khon Kaen, Thailand. Asian Pac J Cancer Prev, 7, 75-8.
  6. Khalid S, Bushra M, Salman NA, et al 2010). Retrospective review of pediatric patients with acute lymphoblastic leukemia: A single center experience. Indian J Pathol Mircrobiol, 53, 704-710. https://doi.org/10.4103/0377-4929.72044
  7. Lanzkowsky P, Cohen S, Cohen A (2011). Leukemia. In: Manual of pediatric hematology and oncology. Fifth edition, Elsevier, 518-566
  8. Long Jun Gu, Juan Li, Hui Liang Xue, et al (2008). Clinical outcome of children with newly diagnosed acute lymphoblastic leukemia treated in a single center in Shanghai, China. Leukemia Lymphoma, 49, 488-94. https://doi.org/10.1080/10428190701784730
  9. Moghrabi A, Levy DE, Asselin B, et al (2007). Results of the Dana-Farber Cancer Institute ALL Consortium Protocol 95-01 for children with acute lymphoblastic leukemia. Blood, 109, 896-904.
  10. National Health Security Office (2006). National Protocol for childhood leukemia.
  11. Schmoor C, Sauerbrei W, Schumacher M (2000). Sample size considerations for the evaluation of prognostic factors in survival analysis. Stat Med, 19, 441-52. https://doi.org/10.1002/(SICI)1097-0258(20000229)19:4<441::AID-SIM349>3.0.CO;2-N
  12. Silverman LB, Stevenson KE, O'Brien JE, et al (2010). Long-term results of Dana-Farber Cancer Institute ALL Consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000). Leukemia, 24, 320-34. https://doi.org/10.1038/leu.2009.253
  13. Srivannaboon K (1997). Immunophenotype on acute leukemia in children at Siriraj Hospital analysis of 145 cases. Thai J Pediatr, 36, 111-2.
  14. Suesirisawad C, Chainansamit S, Sriraksa K (2006). Survival analysis of children with acute lymphoblastic leukemia at Khon Kaen hospital. Khon Kaen Hospital Med J, 30, 159-67.
  15. Wiangnon S, Veerakul G, Nuchprayoon I, et al (2011). Childhood cancer incidence and survival 2003-2005, Thailand: Study from the Thai Pediatric Oncology Group. Asian Pac J Cancer Prev, 12, 2215-20.
  16. World Health Organization (2000). International classification of disease for oncology. Fritz A, Percy C, Jack A, et al, eds. Third ed. WHO, Geneva.

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