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Overall and event-free survivals for acute lymphoblastic leukemia in children at a single institution in Taiwan
Hsi-che Liu1, Shu-Huey Chen, Kou-Hwa Chang
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
Insights
Long-term treatment for childhood acute lymphoblastic leukemia (ALL) shows encouraging survival rates. This study tracked 151 patients, highlighting improved outcomes and reduced dropout rates over time.
Area of Science:
- Pediatric Oncology
- Hematology
Background:
- Childhood acute lymphoblastic leukemia (ALL) treatment outcomes have significantly improved globally over the past 30 years.
- Mackay Memorial Hospital conducted four consecutive clinical trials for ALL patients between 1982 and 1993.
Purpose of the Study:
- To present the long-term outcomes of childhood ALL patients treated at Mackay Memorial Hospital.
- To evaluate the effectiveness of a consistent treatment backbone with intensified therapy for high-risk patients.
Main Methods:
- Analysis of 151 pediatric ALL patients enrolled in four clinical trials (1982-1993).
- Treatment included 3-4 drug remission induction, central nervous system (CNS)-directed therapy, and maintenance with vincristine and dexamethasone.
- Intensified therapy (reintensification, additional drugs) was used for high-risk and very-high-risk patients.
Main Results:
- Overall survival was 70% +/- 4.1%, and event-free survival was 64% +/- 4.3%.
- The isolated central nervous system (CNS) relapse rate was 4.3%.
- Patient dropout rates decreased significantly from 35% (1982-1984) to 0% (1991-1993).
Conclusions:
- The long-term results for childhood ALL at Mackay Memorial Hospital are encouraging, especially compared to earlier Taiwanese reports.
- The study demonstrates the feasibility of achieving improved survival and reduced dropout rates with consistent therapeutic strategies.
Abstract:
The results of treatment for childhood acute lymphoblastic leukemia (ALL) have improved dramatically over the past three decades. The authors present the long-term outcome of patients (n = 151) with ALL enrolled in 4 consecutive clinical trials conducted from 1982 to 1993 at Mackay Memorial Hospital. During this period, the backbone of the treatment remained relatively unchanged, including a 3- to 4-drug remission induction, central nervous system (CNS)-directed therapy, and cyclic pulses of vincristine and dexamethasone during maintenance therapy. More intensive therapy, consisting of reintensification and addition of more drugs during maintenance, was reserved for high-risk and very-high-risk patients. The overall survival and event-free survival (+/- 1 SE) were 70 +/- 4.1% and 64 +/- 4.3 %, respectively, with follow-up ranging from 7.6 to 18.7years (median 12.2 year). The isolated CNS relapse rate was 4.3%. The dropout rate significantaly decreased from 35% in 1982-1984 to 0% in 1991-1993. Although the patient population is small, the overall results for childhood ALL at the authors' hospital are encouraging as compared to earlier reports in Taiwan.
