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Outcomes in Pediatric Acute Lymphoblastic Leukemia-A Single-Center Romanian Experience
Mirabela-Smaranda Alecsa1,2, Mihaela Moscalu3, Laura-Mihaela Trandafir1,4
1Department Mother and Child Care, Division of Neonatology, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Insights
This study assessed Romanian children with acute lymphoblastic leukemia (ALL) treated with an adapted BFM 2002 protocol. Outcomes showed encouraging survival rates, though slightly lower than in developed nations.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Research
Background:
- Acute lymphoblastic leukemia (ALL) is a significant pediatric cancer.
- Understanding treatment outcomes in diverse populations is crucial for improving care.
- This study focuses on Romanian children undergoing specific ALL treatment protocols.
Purpose of the Study:
- To evaluate the clinical and paraclinical aspects of acute lymphoblastic leukemia (ALL) in Romanian children.
- To assess treatment outcomes, including remission rates, relapse rates, and survival rates.
- To compare findings with international data and identify areas for improvement.
Main Methods:
- Retrospective single-center study of 125 children diagnosed with ALL between 2010 and 2016.
- Data collected using standard forms for clinical and paraclinical parameters.
- Molecular analysis (RT-PCR) performed for specific fusion genes in 111 patients.
Main Results:
- Median age at diagnosis was 5 years; 64.8% were male.
- Precursor B-cell ALL (BCP-ALL) diagnosed in 107 patients, T-cell ALL (T-ALL) in 18.
- ETV6-RUNX1 translocation found in 18.9% of patients; BCR-ABL1 in 2.7%; E2A-PBX1 in 3.6%.
- Complete remission achieved in 89.6% of patients.
- Overall relapse rate was 11.2% (11 early, 3 late).
- 5-year overall survival: 81.6% for BCP-ALL, 71.4% for T-ALL.
Conclusions:
- The 5-year overall and event-free survival rates were slightly lower than in developed countries.
- Despite this, the patients' outcomes are considered encouraging.
- Findings highlight the need for continued efforts to optimize ALL treatment protocols and patient care.
Background:
This study evaluates the main (para)clinical aspects and outcomes in a group of Romanian children diagnosed with acute lymphoblastic leukemia (ALL), under the conditions of antileukemic treatment according to an adapted ALL IC Berlin-Frankfurt-Munster (BFM) 2002 protocol.
Methods:
We performed a retrospective single-center study of 125 children diagnosed with ALL between 2010 and 2016. Standard forms were used for data collection of variate clinical and paraclinical parameters.
Results:
The children were predominantly male (64.8%) and their median age at diagnosis was 5 years. A total of 107 patients were diagnosed with precursor B-cell acute lymphoblastic leukemia (BCP)-ALL and 18 with T-cell acute lymphoblastic leukemia T-ALL. Multiplex reverse transcription polymerase chain reaction RT-PCR assay for ETV6-RUNX1, BCR-ABL, E2A-PBX1, KMT2A-AFF1, and STIL-TAL1 fusion genes was performed in 111 patients. ETV6-RUNX1 translocation was detected in 18.9% of patients, while BCR-ABL1 and E2A-PBX1 rearrangements were seen in 2.7% and 3.6%, respectively. Complete remission at the end of induction phase was obtained in 89.6% of patients. The overall relapse rate was 11.2%, with 11 early and 3 late relapses. The 5-year overall survival rate in BCP-ALL was 81.6% and in T-ALL 71.4%.
Conclusions:
The 5-year overall and event-free survival rates in our study were slightly lower than those reported in developed countries, so the patients' outcomes are encouraging.
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