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Outcome of childhood acute lymphoblastic leukemia in Jordan
Hadeel Halalsheh1, Najyah Abuirmeileh, Rawad Rihani
1Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan.
Insights
Childhood acute lymphoblastic leukemia (ALL) survival rates were evaluated in low- and middle-income countries. Modified protocols showed high survival, suggesting adaptability for global pediatric cancer treatment.
Area of Science:
- Pediatric Oncology
- Hematology
- Epidemiology
Background:
- Limited data exists on childhood acute lymphoblastic leukemia (ALL) in low- and middle-income countries.
- King Hussein Cancer Center (KHCC) initiated a study to assess ALL survival rates.
Purpose of the Study:
- To evaluate the survival outcomes of childhood ALL patients treated at KHCC.
- To assess the efficacy of modified St. Jude Children's Research Hospital protocols in a resource-limited setting.
Main Methods:
- Retrospective review of medical records for children (1-18 years) diagnosed with ALL between January 2003 and December 2009.
- Analysis of disease characteristics, treatment protocols, and patient outcomes.
Main Results:
- 300 children with ALL were treated, with a median age of 5 years.
- 5-year event-free survival was 80% and overall survival was 89%.
- Common cytogenetic abnormalities included t(12;21) and t(9;22).
Conclusions:
- Successfully adapted treatment protocols from major cooperative groups demonstrate feasibility.
- This approach may offer a viable strategy for improving childhood ALL outcomes in similar healthcare settings globally.
Background:
Accurate data about childhood acute lymphoblastic leukemia (ALL) in low- and middle-income countries are lacking. Our study is designed to assess survival of childhood ALL at King Hussein Cancer Center (KHCC) using modified St. Jude Children's Research Hospital protocols.
Patients And Methods:
We reviewed the medical records of children 1-18 years of age who were diagnosed with ALL and treated at KHCC from January 2003 through December 2009. Disease characteristics and outcome were analyzed.
Results:
Over a 7-year period, 300 children with ALL were treated. One hundred and seventy-three (57.7%) were males and 127 (42.3%) were females. The median age at diagnosis was 5 years. One hundred and fifty-seven (52.3%) children were classified as low-risk, 118 (39.3%) were standard-risk and 25 (8.3%) were high-risk. Two hundred and sixty-two (88.5%) children had pre-B cell phenotype and 34 (11.5%) had T-cell phenotype. Two hundred and seventy-three (91.3%) children were classified as having CNS I disease, 24 (8%) had CNS II, and 2 (0.67%) had CNS III. Cytogenetic abnormalities included: t(12;21) in 30 (12%) children and t(9;22) in 18 (7.4%). Four (1.3%) children died in induction, 6 (2%) died in first remission and 27 (9%) relapsed. After a median follow-up of 34.5 months (range 0.32-84.5), the estimated 5-year event free survival and overall survival were 80% and 89%, respectively.
Conclusion:
Treatment protocols developed by major cooperative groups and institutions to treat childhood ALL was successfully adapted and suggest that such an approach may be useful in other low- and middle-income countries.
