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Infant lymphoblastic leukemia: a single centers 10 year experience
İnci Yaman-Bajin1, Selin Aytaç1, Barış Kuşkonmaz1
1Division of Pediatric Hematology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Insights
Infant acute lymphoblastic leukemia (ALL) has a poor prognosis, with only 45% of patients surviving. Hematopoietic stem cell transplantation (HSCT) shows promise for selected infants, but eligibility criteria need further study.
Area of Science:
- Pediatric Hematology
- Oncology
- Immunology
Background:
- Infant acute lymphoblastic leukemia (ALL) is a rare and aggressive form of childhood cancer.
- Infants with ALL face a poorer prognosis compared to older children despite advancements in treatment.
Purpose of the Study:
- To retrospectively evaluate the clinical characteristics and treatment outcomes of infants diagnosed with ALL.
- To assess the effectiveness of hematopoietic stem cell transplantation (HSCT) in this patient group.
Main Methods:
- Retrospective analysis of 13 infant ALL patients treated at Hacettepe University between 2008 and 2018.
- Evaluation of clinical features, treatment protocols (chemotherapy and HSCT), and patient outcomes, including relapse and survival rates.
Main Results:
- The median age of patients was 7 months, with a notable occurrence of triplets (3/13).
- Relapse occurred in 4 patients; 5 underwent HSCT, with 3 experiencing relapse post-transplant.
- Overall survival in remission was 45% (6/13) after a median follow-up of 18 months.
Conclusions:
- Infant ALL carries a poor prognosis, with approximately half of the patients surviving.
- Hematopoietic stem cell transplantation (HSCT) appears to be an effective treatment option for select infant ALL patients.
- Further research is essential to refine eligibility criteria for HSCT in this vulnerable population.
Abstract:
Yaman-Bajin İ, Aytaç S, Kuşkonmaz B, Uçkan-Çetinkaya D, Ünal Ş, Gümrük F, Çetin M. Infant lymphoblastic leukemia: a single centers 10 year experience. Turk J Pediatr 2019; 61: 325-329. Infant acute lymphoblastic leukemia (ALL) is a rare disease and consists of 4-5% of all childhood ALL. Despite improved survival rates in childhood ALL, infants with ALL have a worse prognosis. We aimed to evaluate the clinical features and treatment outcomes of our patients diagnosed with infant ALL at Hacettepe University, Pediatric Hematology Department between 1 January 2008 and 1 January 2018 retrospectively. There were 13 patients with a median age of 7 months. Three of the patients were triplets born from a spontaneous monozygotic triplet pregnancy. Relapse were observed in 4 patients. Hematopoietic stem cell transplantation (HSCT) was performed for five patients. Relapse after HSCT was observed in 3 patients. After a median follow-up period of 18 months, 6 patients (45%) (3 after HSCT and 3 who only received chemotherapy) were alive and in remission. Prognosis of infant ALL is poor in that only half of the patients survive. Our results suggest that bone marrow transplantation seems to be a good and efficient choice of treatment for selected patients. However, there is still a big issue to decide which patient should undergo transplantation and more studies are needed to reevaluate the eligibility criteria for HSCT in this group of patients.
