NO BLASTS AT DAY 8 IS BETTER THAN MORE IN CORTICO-SENSITIVE ACUTE LYMPHOBLASTIC LEUKEMIA OF CHILDREN
Author(s): ,
Imen Frikha
Affiliations:
Hematology Department,Hedi Chaker Hospital, Sfax, Tunisia,Sfax,Tunisia
,
Ines Turki
Affiliations:
Hematology Department,Hedi Chaker Hospital, Sfax, Tunisia,Sfax,Tunisia
,
Moez Medhaffer
Affiliations:
Hematology Department,Hedi Chaker Hospital, Sfax, Tunisia,Sfax,Tunisia
,
Sondes Hdijji
Affiliations:
Hematology Department,Hedi Chaker Hospital, Sfax, Tunisia,Sfax,Tunisia
,
Imen Ben Amor
Affiliations:
Hematology Department,Hedi Chaker Hospital, Sfax, Tunisia,Sfax,Tunisia
,
Maha Charfi
Affiliations:
Hematology Department,Hedi Chaker Hospital, Sfax, Tunisia,Sfax,Tunisia
,
Olfa Kassar
Affiliations:
Hematology Department,Hedi Chaker Hospital, Sfax, Tunisia,Sfax,Tunisia
,
Manel Ghorbel
Affiliations:
Hematology Department,Hedi Chaker Hospital, Sfax, Tunisia,Sfax,Tunisia
,
Faten Kallel
Affiliations:
Hematology Department,Hedi Chaker Hospital, Sfax, Tunisia,Sfax,Tunisia
Moez Elloumi
Affiliations:
Hematology Department,Hedi Chaker Hospital, Sfax, Tunisia,Sfax,Tunisia
EHA Library. Turki I. Jun 14, 2019; 265983; PF193
Dr. Ines Turki
Dr. Ines Turki
Contributions
Abstract

Abstract: PF193

Type: Poster Presentation

Presentation during EHA24: On Friday, June 14, 2019 from 17:30 - 19:00

Location: Poster area

Background
Acute lymphoblastic leukemia (ALL) had a good prognostic in children and young adults. However, some parameters were predictive of a worse outcome, particularly the poor response to prephase. 

Aims

We analysed in this study the impact of persistent blasts at day 8 of pre-phase in cortico-sensitives patients with ALL.

Methods

Between january 2000 and December 2015, we retrospectively analysed the data of 264 children and young adults treated according the EORTC 58951 protocol. Cortico-sensitivity (Cs) was considered if peripheral blast count is less than 1000/mm3 at day 8 of pre-phase. The group of cortico-sensitives ALL was subdivided on two subgroups : the first with no blasts at day 8 (Cs=0) and the second with more (Csǂ0). We analysed the impact of cortico-sensitivity on complete remission (CR), relapse and survival (overall survival (OS), event free survival (EFS) and disease free survival (DFS)).

Results

One hundred ninety two children and 72 young adults were treated according to the EORTC 58951 protocol. Median age was 10 years (1 to 30 years). Sex ratio was 1,5. B and T phenotype were observed in respectively 64 and 36% of cases. The ALL were stratified in low risk (11 patients), average risk (182 patients), and high risk (71 patients). Two hundred and nine patients (79%) were cortico-sensitive, among them 150 patients (72%) had no blast at day 8 of pre-phase. The therapeutics results in our study and into the two groups of cortico-sensitivity were shown in this table :

 

All patients

Corticosensitivity group

Corticoresistant

Corticosensitive

p

Cs = 0

Cs ǂ 0

p

Complete remission

82%

93%

0.6

95%

89%

0.31

Relapse

38%

27%

0.12

18%

51%

<10-5

OS  

5 years

35%

68%

<10-5

73%

55%

0.061

EFS

5 years

35%

63%

<10-4

69%

47%

0.005

DFS

5 years

52%

72%

0.004

82%

50%

<10-5

Conclusion

Cortico-sensitivity is one of several parameters that predict good outcome in ALL. Moreover, our study showed that no blasts in peripheral blood smears at day 8of prephase can be considered a good first marker of early blastic clearance and good outcome. In fact, this parameter does not discussed previously in the literature.

Session topic: 2. Acute lymphoblastic leukemia - Clinical

Keyword(s): Acute lymphoblastic leukemia

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