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

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.

• Authors: Eu Jeen Yang, Kyung Mi Park, Jae Min Lee, Jeong Ok Hah, Sang Kyu Park, Jin Kyung Suh, Ji Yoon Kim, Kun Soo Lee, Jikyoung Park, Eun Sil Park, Jaeyoung Lim, Ye Jee Shim, Heung Sik Kim, Seom Gim Kong, Heewon Chueh, Eun Jin Choi, Jeong A Park, Young Tak Lim
• Journal: Pediatric hematology and oncology (Pediatr Hematol Oncol) Vol. 35 Issue 4 Pg. 276-287 (May 2018) ISSN: 1521-0669 [Electronic] England
• PMID: 30633619 (Publication Type: Journal Article, Multicenter Study)

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (pharmacology, therapeutic use)
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Infant, Newborn
• Male
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy)
• Prognosis
• Republic of Korea
• Retrospective Studies
• Risk Assessment
• Treatment Outcome
• Young Adult