Acute Complications and Survival Analysis of Childhood Acute Lymphoblastic Leukemia: A 15-year Experience |
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| Authors: | Ayşe Pınar Öztürk Başak Koç Bülent Zülfikar |
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| Affiliation: | 1. Department of Pediatrics, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey;2. Department of Pediatric Hematology-Oncology, Istanbul University Oncology Institute, Istanbul, Turkey;1. Hematology/Oncology, Keesler Medical Center, Keesler Air Force Base, Biloxi, MS;2. Department of Pathology, Keesler Medical Center, Keesler Air Force Base, Biloxi, MS;3. United States Army Institute of Surgical Research, Uniformed Services University, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX;1. Hematology Department, Centre de lutte contre le cancer Léon Bérard, Lyon, France;2. Nephrology Department, Pitié-Salpêtrière University Hospital, Paris, France;3. Department of Mycology, Rennes University Hospital, Rennes, France;4. Department of Hematology and Cellular Therapy, University Hospital of Bordeaux, Bordeaux, France;5. Liver Unit, St Eloi University Hospital, Montpellier, France;6. Quality Unit, Pôle Prébloc, Saint-Louis and Lariboisière Hospital Group, Assistance Publique-Hôpitaux de Paris, Paris, France;7. Intensive Care Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France;8. Pharmacy Department, Strasbourg University Hospitals, Strasbourg, France;9. Hematology Department, Lille Regional University Hospital, Lille, France;10. Medical Intensive Care Unit, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France;11. Intensive Care and Infectious Disease Unit, Tourcoing Hospital, University of Lille, Tourcoing, France;12. Department of Oncology and Hematology, Strasbourg University Hospitals and Strasbourg University, Strasbourg, France;1. The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China;2. The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China;3. University of Chinese Academy of Sciences, Beijing, China;4. The Fifth Medical Center of Chinese PLA General Hospital, Beijing, China;1. Department of Pediatrics, Peking University People’s Hospital, Peking University, Beijing, China;2. Department of Hematology, Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China; Peking-Tsinghua Center for Life Sciences and Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, China;1. Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy;2. “Seràgnoli” Institute of Hematology, Bologna University School of Medicine, Bologna, Italy |
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| Abstract: | BackgroundWe evaluated the acute complications that occurred during the treatment of childhood acute lymphoblastic leukemia (ALL) and documented the survival rates of children with ALL.Materials and MethodsWe retrospectively evaluated 110 children with a diagnosis of ALL treated with the Children’s Oncology Group protocol from 1999 to 2014. The demographic, clinical, and laboratory data of 110 patients and acute complications of eligible and evaluable 105 patients were recorded.ResultsOf the 110 patients, 65 were male and 45 were female. The mean age at admission was 8.3 ± 5.2 years. Ninety-seven patients (88.2%) had been diagnosed with pre–B-cell ALL, 11 (10%) with T-cell ALL, 1 (0.9%) with mixed phenotype acute leukemia, and 1 (0.9%) with mature B-cell acute leukemia. Of the 110 patients, 40 (36.3%) were in the standard-risk group and 70 (63.7%) were in high-risk group. Of the 110 patients, 105 had been followed up regularly and evaluated for acute complications. Infection was the most common complication (n = 93; 88.5%), followed by gastrointestinal (n = 29; 27.6%), neurologic (n = 28; 26.6%), metabolic/endocrine (n = 16; 15.2%), drug-related hypersensitivity (n = 16; 15.2%), avascular necrosis (n = 13; 12.3%), thrombotic (n = 11; 10.4%), severe psychiatric (n = 2; 1.9%), and various other (n = 12; 11.4%) complications. Of the 110 patients, 98 were assessed in terms of survival analysis. The 5- and 10-year overall survival rates were both 85.9% (standard error [SE], 3.6%). The relapse-free survival rates at 1, 3, and 5 years were 97.9% (SE, 1.5%), 91.3% (SE, 3%), and 86.3% (SE, 3.7%), respectively.ConclusionChildhood ALL, although categorized as curable malignancy owing to the improvements in treatment strategies in recent years, can cause acute complications affecting various systems. Thus, patients should be treated and followed up by multidisciplinary medical teams with high expertise. |
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| Keywords: | Acute leukemia Childhood Complications Relapse Survival |
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