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Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
Long-term outcome of childhood acute lymphoblastic leukemia treated in China
Yongmin Tang1, Xiaojun Xu, Hua Song
1Division of Hematology-Oncology, Children's Hospital Zhejiang University School of Medicine, Hangzhou, PR China. y_m_tang@zju.edu.cn
Insights
Treatment abandonment significantly impacts outcomes for children with acute lymphoblastic leukemia (ALL). Improving socioeconomic support is crucial for improving survival rates in pediatric ALL patients.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Research
Background:
- Retrospective analysis of childhood acute lymphoblastic leukemia (ALL) treatment outcomes.
- Focus on treatment failure causes in a single East China institution.
Purpose of the Study:
- Determine treatment outcomes for pediatric ALL patients.
- Identify causes of treatment failure, particularly abandonment.
- Evaluate the efficacy of the NPCAC97 protocol.
Main Methods:
- Analysis of 346 newly diagnosed ALL patients (<16 years) from 1998-2004.
- Evaluation of 248 patients who received at least two weeks of NPCAC97 treatment.
- Assessment of treatment abandonment rates and survival data.
Main Results:
- Treatment abandonment occurred in 48.3% of patients, significantly higher in rural areas (57.3%).
- Five-year event-free survival (EFS) for the entire cohort was 38.5%.
- For evaluable patients, remission rate was 97.2%, with 5-year EFS of 70.7% and overall survival (OS) of 82.1%.
Conclusions:
- Chemotherapy abandonment is the primary cause of treatment failure in pediatric ALL.
- Poor socioeconomic status and lack of financial support are linked to higher abandonment rates.
- Adherence to treatment protocols leads to favorable outcomes in pediatric ALL.
Background:
To retrospectively determine the treatment outcome and causes of treatment failure of ALL children treated in a single institution at East China.
Procedure:
Between January 1998 and October 2004, 346 newly diagnosed ALL patients
Results:
Among the 346 newly diagnosed patients, 167 (48.3%) stopped treatment either at diagnosis or during therapy. The abandonment rates for urban area group (UAG) and rural area group (RAG) were 25.3% and 57.3%, respectively (P < 0.0001). The 5-year event-free survival (EFS) rate for the entire cohort was 38.5 +/- 2.7%. For 248 evaluable patients, the remission rate was 97.2%. The 5-year EFS and overall survival (OS) rates were 70.7 +/- 3.6% and 82.1 +/- 3.0%, respectively. The 5-year EFS for standard-risk group (n = 196) was significantly higher than that of high-risk group (n = 52) (75.9 +/- 3.9% vs. 50.7 +/- 8.0%, P = 0.0002). Prognostic factor analysis showed that poor response to remission induction therapy and a poor socioeconomic status were predictive for an inferior outcome.
Conclusion:
Abandonment of chemotherapy was the most common cause of treatment failure, which was strongly related to poor socioeconomic status and financial support. For patients who could adhere to the treatment protocol, a relatively good outcome was achieved.