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Improved Outcomes of Childhood Acute Lymphoblastic Leukemia: A Retrospective Single Center Study in Saudi Arabia
Abdullateef Mohammed Ahmed1, Hassan Al-Trabolsi1, Mohammed Bayoumy1
1King Faisal Specialist Hospital and Research Center, Jeddah Branch, Alrawdah, Jeddah, Makkah, Kingdom of Saudi Arabia.
Insights
Pediatric acute lymphoblastic leukemia (ALL) patients in Saudi Arabia show clinical and genetic profiles similar to Western countries. Local treatment infrastructure now achieves comparable survival outcomes, closing the previous gap.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Genetics
Background:
- Understanding clinical and genetic factors in pediatric acute lymphoblastic leukemia (ALL) is crucial for effective treatment assignment.
- Real-world data on patient characteristics, treatment practices, and outcomes in pediatric ALL are essential for improving care.
Purpose of the Study:
- To investigate the clinical and genetic characteristics of pediatric ALL patients.
- To analyze real-world treatment practices and outcomes for pediatric ALL in Saudi Arabia.
- To compare outcomes with international standards and assess the impact of local infrastructure.
Main Methods:
- Retrospective analysis of 213 pediatric ALL patients treated between January 2002 and December 2015.
- Evaluation of demographic, clinical, and genetic data, including chromosomal abnormalities.
- Survival analysis using Kaplan-Meier method and Log-Rank tests.
Main Results:
- The cohort median age was 5 years, with 55.4% males. Pre-B-cell ALL was predominant (88.7%).
- Most patients had low white blood cell counts (<50,000/μL) and 8.5% had central nervous system involvement.
- Common chromosomal abnormalities were identified. High rates of early treatment response (91.1%) and end of induction (96.2%) were observed.
Conclusions:
- Clinical characteristics and genetic abnormalities in this cohort resemble those in Western populations.
- Saudi Arabia has closed the survival gap with Western countries for pediatric ALL.
- Competitive patient outcomes are achievable with the existing local healthcare infrastructure.
Objective:
Understanding the clinical and genetic characteristics of pediatric acute lymphoblastic leukemia (ALL)
patients may help assigning the appropriate treatment. This study aims to understand patients' characteristics, "real-world"
treatment practice and outcomes of pediatric ALL.
Methods:
A cohort of 213 pediatric ALL patients, treated at (King
Faisal Specialist Hospital and Research Center -Jeddah branch) KFSH and RC-J during the period of January 2002 to
December 2015 were analyzed retrospectively. Statistical analyses were performed on patients' demographic, clinical
and genetics characteristics and outcomes of different treatment protocols. Survival was evaluated using Kaplan-Meier
method, and differences in survival were tested using Log-Rank. Significance was set at 0.05 level.
Results:
Median
age of the study cohort was 5 years (range 0.5-15 years) with 55.4% of male population. Majority of the patients had
pre-B-cell ALL (88.7%), WBC count <50, 000/μL at diagnosis (76.1%, median = 13.5/μL with a range of 0.51-553.0/
μL) with involvement of central nervous system (CNS) disease in 8.5%patients.Different common chromosomal
anomalies or abnormalities, including t(12, 21) translocation, MLL genre arrangements, trisomy (4, 10, 17)and others,
were detected. Early response to the risk-directed treatment received by the patients (91.1% achieving <5% blast in
the bone marrow) as well as the end of induction outcome (96.2%) was encouraging.
Conclusion:
We found that the
patients' clinical characteristics and distribution of genetic abnormalities were similar to those of the western countries.
Our findings show that the earlier gap between the western countries and KSA in terms of survival has been closed and
that competitive outcomes can be achieved with local infrastructure.
