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Survival outcome in childhood ALL: experience from a tertiary care centre in North India

K P Kulkarni1, R K Marwaha, A Trehan

  • 1Division of Pediatric Hematology-Oncology, Advanced Pediatric Center, PGIMER, Chandigarh, India.

Pediatric Blood & Cancer
|May 1, 2009
PubMed

Insights

Childhood acute lymphoblastic leukemia (ALL) survival lags in developing nations. Key risk factors include symptom-diagnosis interval, high white cell count (WCC), and low platelet count, impacting treatment outcomes.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Epidemiology

Background:

  • Childhood acute lymphoblastic leukemia (ALL) survival rates in developing countries lag significantly behind those in developed nations.
  • This study aimed to evaluate survival data and identify critical risk factors in a cohort of children with ALL in a developing nation.

Purpose of the Study:

  • To assess the survival outcomes of children diagnosed with acute lymphoblastic leukemia (ALL).
  • To identify clinical and demographic risk factors influencing survival in pediatric ALL patients.

Main Methods:

  • Analysis of clinical-demographic data from 762 pediatric ALL patients.
  • Generation of Kaplan-Meier survival curves to evaluate overall survival (OS) and event-free survival (EFS).
  • Multivariate Cox regression analysis to identify significant predictors of outcome.

Main Results:

  • The 5-year OS and EFS were 46% and 43%, respectively.
  • Significant predictors of outcome included symptom-diagnosis interval, high white cell count (WCC), low platelet count, bulk disease, mediastinal adenopathy, and receipt of two intensification blocks.
  • Approximately 30% of patients opted out of therapy, with high rates of treatment default, loss to follow-up, and infection-related deaths.

Conclusions:

  • Effective management of childhood ALL necessitates adequate financial resources and supportive care.
  • Addressing high rates of therapy refusal, default, loss to follow-up, and infection-related mortality is crucial for improving cure rates.
  • Implementing targeted remedial measures can enhance ALL treatment outcomes in developing nations.
Abstract

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