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Pediatr Hematol Oncol. 2018 May;35(4):276-287. doi: 10.1080/08880018.2018.1483986. Epub 2019 Jan 11.

Treatment outcome of pediatric acute lymphoblastic leukemia in Yeungnam region: Multicenter retrospective study of Study Alliance of Yeungnam Pediatric Hematology-Oncology (SAYPH).

Author information

1
a Department of Pediatrics , Pusan National University Children's Hospital, Pusan National University School of Medicine , Yangsan , Republic of Korea.
2
b Department of Pediatrics , College of Medicine, Yeungnam University , Daegu , Republic of Korea.
3
c Department of Pediatrics , Daegu Fatima Hospital , Daegu , Republic of Korea.
4
d Department of Pediatrics , Ulsan University Hospital , Ulsan , Republic of Korea.
5
e Department of Pediatrics, School of Medicine , Kyungpook National University , Daegu , Republic of Korea.
6
f Department of Pediatrics , Inje University College of Medicine, Busan Paik Hospital , Busan , Republic of Korea.
7
g Department of Pediatrics , Gyeongsang National University School of Medicine , Jinju , Republic of Korea.
8
h Department of Pediatrics , Keimyung University School of Medicine and Dongsan Medical Center , Daegu , Republic of Korea.
9
i Department of Pediatrics , Kosin University College of Medicine , Busan , Republic of Korea.
10
j Department of Pediatrics , Dong-A University College of Medicine , Busan , Republic of Korea.
11
k Department of Pediatrics , Daegu Catholic University Medical Center , Daegu , Republic of Korea.
12
l Department of Pediatrics , Inje University Haeundae Paik Hospital , Busan , Republic of Korea.

Abstract

OBJECTIVES:

We aimed to evaluate treatment outcomes of pediatric acute lymphoblastic leukemia (ALL) subgroups by risk-stratification, in the Yeungnam region of Korea.

METHODS:

We reviewed the courses of 409 newly diagnosed ALL patients from January 2004 to December 2013 in the Yeungnam region.

RESULTS:

All patients were classified into three risk groups: standard risk (SR, n=212), high risk (HR, n=153) and very high risk (VHR, n=44). The mean follow-up time was 73.6 ± 39.4 months. The 7-year event-free survival (EFS) and overall survival (OS) rates were 78.7 ± 2.1% and 86.8 ± 1.8%, respectively. Significant 7-year EFS and OS rates for SR (84.0 ± 2.7%, 93.7 ± 1.8%), HR (76.5 ± 3.5%, 82.1 ± 3.3%), and VHR (60.6 ± 7.5%, 69.9 ± 7.5%) were observed (P<0.001), respectively. Relapse occurred in 52 patients, and the cumulative 7-year incidence of relapse differed according to risk groups (SR vs. HR vs. VHR=12.6% vs. 14.0% vs. 29.6%, P=0.003).For the 46 relapsed patients who were treated, the 3-year EFS and OS were 42.3 ± 8.3%and 46.4± 8.4%. Among the 44 VHR patients, EFS was not significantly different between the chemotherapy-treated patients and those received hematopoietic stem cell transplantation (P=0.533). The 7-year EFS of the hyperleukocytosis subgroup (24 cases, 14 under 10 years of age)showed a tendency for better prognosis than that of the other VHR subgroups (P=0.178).

CONCLUSION:

Our results revealed improved outcomes in pediatric ALL patients with risk-stratified therapy. The hyperleukocytosis subgroup without any combined chromosomal abnormalities may respond favorably to chemotherapy alone after first complete remission.

KEYWORDS:

Outcome; pediatric acute lymphoblastic leukemia (ALL); risk-stratified therapy

PMID:
30633619
DOI:
10.1080/08880018.2018.1483986
[Indexed for MEDLINE]

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