Contributions
Abstract: PB1637
Type: Publication Only
Background
Acute lymphoblastic leukemia (ALL) is a malignant disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic marrow cell.
Aims
We retrospectively evaluated the treatment results of children with de nova ALL treated with BFM ALL (1990- 1995-2000-2009) protocols between the years 1993 and 2017.
Methods
The overall (OS) and event free (EFS) survivals according to age, initial leukocyte count, immunophenotype, chemotherapy responses (on days 8, 15, and 33), and risk groups were analyzed by Kaplan–Meier survival analysis by SPSS 2009.
In total ,MRD(minimal residual disease) analysis was avaliable in 33% (n=141)of children either with flowcytometry or PCR .
Results
The data of 460 children diagnosed as de nova ALL were retrospectively evaluated.
Male (291)/Female (169) ratio was:1.7 and median age was 6.9 years (0.5–17.8)
Median follow-up time was 7,7 years.(1-297 months). Children were classified as high risk ( 28% ), medium risk(60.2%), and stantard risk(9.3% ) groups.Relapse time was defined according to BFM definition.( Late relapse>30 months, early relaps 18-30 months and very early relapse<18 months from the initial time of diagnosis) Complete remission was achieved in 97 % of children. EFS and OS at 5 years were found 78.8 and 82.3 %, respectively. Children younger than 6 years old had better EFS and OS (83.7 and 85.2 %) than children aged ≥6 years (71.4 and 72.8 %)(p=0.23). Patients who had initial leukocyte counts of <20 × 109/L had better EFS and OS (80.6 and 84 %) than children with higher initial leukocyte counts (76 and 80.2 %)(p=0.22). The majority of the patients were B cell (80.2%) and the rest were T cell ALL(19.8%). EFS for B and T-cell ALL was 84.3 and 76.4 %, respectively(p=0.128). Children with a prednisolone good response on day 8 (83,5%) achieved significantly better EFS and OS (80.3 and 84.6 %) vs. (71.2 and 71%)(p=0.025). İn children whose bone marrow on day 15 m1 and m2 bone marrow (M1 and M2 bone marrow) had also higher EFS and OS (82.8 and 85.9 % vs. 71 and 77.5 %)(p=0.001)than the childrem with m3. Children in the standard-risk and medium-risk groups obtained significantly higher EFS (88.4 and 81.5 %) OS (90.7 and 86.6 %) compared to the high-risk group (EFS 75.6 %, OS 76.6%)(p=0.001). The relapse rate was found 18 %. The median relapse time from diagnosis was 29 months.(3 –129). Late relapses had higher OS (33.3%) than very early and early relapse cases (15%), respectively(p=0.003). Death occurred in 82 of 460 patients (17.8 %). The major causes of death were neutropenic sepsis and relapse disease.
Conclusion
The high survival rate with BFM based ALL protocols were obtained in our center.These protocols can be succesfully applied in treatment of childhood leukemia in countries with limited sources.
Session topic: 2. Acute lymphoblastic leukemia - Clinical
Keyword(s): ALL, Treatment
Abstract: PB1637
Type: Publication Only
Background
Acute lymphoblastic leukemia (ALL) is a malignant disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic marrow cell.
Aims
We retrospectively evaluated the treatment results of children with de nova ALL treated with BFM ALL (1990- 1995-2000-2009) protocols between the years 1993 and 2017.
Methods
The overall (OS) and event free (EFS) survivals according to age, initial leukocyte count, immunophenotype, chemotherapy responses (on days 8, 15, and 33), and risk groups were analyzed by Kaplan–Meier survival analysis by SPSS 2009.
In total ,MRD(minimal residual disease) analysis was avaliable in 33% (n=141)of children either with flowcytometry or PCR .
Results
The data of 460 children diagnosed as de nova ALL were retrospectively evaluated.
Male (291)/Female (169) ratio was:1.7 and median age was 6.9 years (0.5–17.8)
Median follow-up time was 7,7 years.(1-297 months). Children were classified as high risk ( 28% ), medium risk(60.2%), and stantard risk(9.3% ) groups.Relapse time was defined according to BFM definition.( Late relapse>30 months, early relaps 18-30 months and very early relapse<18 months from the initial time of diagnosis) Complete remission was achieved in 97 % of children. EFS and OS at 5 years were found 78.8 and 82.3 %, respectively. Children younger than 6 years old had better EFS and OS (83.7 and 85.2 %) than children aged ≥6 years (71.4 and 72.8 %)(p=0.23). Patients who had initial leukocyte counts of <20 × 109/L had better EFS and OS (80.6 and 84 %) than children with higher initial leukocyte counts (76 and 80.2 %)(p=0.22). The majority of the patients were B cell (80.2%) and the rest were T cell ALL(19.8%). EFS for B and T-cell ALL was 84.3 and 76.4 %, respectively(p=0.128). Children with a prednisolone good response on day 8 (83,5%) achieved significantly better EFS and OS (80.3 and 84.6 %) vs. (71.2 and 71%)(p=0.025). İn children whose bone marrow on day 15 m1 and m2 bone marrow (M1 and M2 bone marrow) had also higher EFS and OS (82.8 and 85.9 % vs. 71 and 77.5 %)(p=0.001)than the childrem with m3. Children in the standard-risk and medium-risk groups obtained significantly higher EFS (88.4 and 81.5 %) OS (90.7 and 86.6 %) compared to the high-risk group (EFS 75.6 %, OS 76.6%)(p=0.001). The relapse rate was found 18 %. The median relapse time from diagnosis was 29 months.(3 –129). Late relapses had higher OS (33.3%) than very early and early relapse cases (15%), respectively(p=0.003). Death occurred in 82 of 460 patients (17.8 %). The major causes of death were neutropenic sepsis and relapse disease.
Conclusion
The high survival rate with BFM based ALL protocols were obtained in our center.These protocols can be succesfully applied in treatment of childhood leukemia in countries with limited sources.
Session topic: 2. Acute lymphoblastic leukemia - Clinical
Keyword(s): ALL, Treatment