Relapses Children's Acute Lymphoblastic Leukemia, Single Center Experience

Area of Science:

• Pediatric Oncology
• Hematology
• Cancer Research

Background:

• Relapsed acute lymphoblastic leukemia (ALL) in pediatric patients presents a significant therapeutic challenge, even with advanced treatments like hematopoietic stem cell transplantation.
• Identifying prognostic factors is crucial for improving outcomes in children and adolescents with relapsed ALL.

Purpose of the Study:

• To analyze the incidence of relapsed ALL in pediatric patients.
• To evaluate survival rates in correlation with identified risk factors.
• To determine the impact of relapse timing and leukemia subtype on prognosis.

Main Methods:

• Retrospective analysis of 125 pediatric ALL patients diagnosed between 2000-2018.
• Data collection included patient demographics, relapse details (timing, site), and survival outcomes.
• Statistical analysis to correlate risk factors with five-year overall survival.

Main Results:

• A relapse incidence of 15.2% was observed among pediatric ALL patients.
• Early relapse timing (63.1%) was more common than very early (15.8%) or late (21.1%) relapses.
• Five-year survival was achieved by 31.6% of patients, with a significant association between relapse type and survival (p < 0.05).
• Patients with very early relapses had a 0% five-year survival rate.

Conclusions:

• The timing of relapse onset is a primary prognostic factor in pediatric ALL.
• T-lineage ALL is identified as a significant adverse prognostic indicator.
• Integrating relapse risk factors with cytogenetic markers and minimal residual disease assessment is vital for optimizing first-line chemotherapy and personalizing ALL treatment strategies.