Survival and prognostic factors of childhood acute lymphoblastic leukemia
Keywords:
lymphoblastic leukemia, acute, childhood, outcome studies, survival
Abstract
Background The treatment protocols of childhood acutelymphoblastic leukemia (ALL) have been improved.
Some factors such as age, sex, and nutritional status could
influence therapy outcome.
Objective To study the survival differences among age, sex,
and nutritional status groups in childhood ALL.
Methods A retrospective Kaplan-Meier survival analysis of
childhood ALL was performed in Cipto Mangunkusumo
Hospital since January 1st 1998 until December 31st 2003.
We excluded patients aged < 1 years, those with L3 subtype,
patients with modified chemotherapy protocol, or with
incomplete data.
Results A total of 252 patients were analyzed. Overall
survival of 1-2 year old, > 2-< 10 year old, and 10-18 year
old subjects were 57% (95% CI 38 to 76%), 47% (95% CI
40 to 54%), and 35% (95% CI 21 to 49%) respectively (P
< 0.05). Five-year -event-free survival (EFS) of 1-2 year old,
> 2-< 10 year old, and 10-18 year old subjects were 40%,
40%, and 16%, respectively (P <0.05). Overall survival of
male and female subjects were 46% and 53% respectively
(P >0.05). Five-year-EFS of male and female subjects were
29% and 45% (P >0.05). Overall survival of well-nourished,
undernourished, and malnourished patients were 42%50%
and 57% respectively (P >0.05). The five-year-EFS of wellnourished, undernourished, and malnourished subjects were
33%,38%, and 51%, respectively (P >0.05).
Conclusion Childhood ALL aged 1-2 years had the highest
survival rate while those of 10-18 year old had the lowest. There
were no survival rate differences between sex and nutritional
status groups.
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S. Nutritional status and socio-economic conditions as
prognostic factors in the outcome of therapy in childhood acute
lymphoblastic leukemia. IntJ Cancer. 1998;(11):52-55.
Cabrera ME, eta!. Improved outcome for acute lymphoblastic
leukemia in children of developing country: results of the
Chilean National Trial PINDA 87. Med Pediatr Oncol.
1999;33:88-94.
2. Karimi M, Yarmohammadi H, Sabri MR. An analysis
of prognostic factors and the five years survival rates in
childhood acute lymphoblastic leukemia. Med Sci Monit.
2002;8:792-6.
3. Howard SC, Pedrosa M, Lins M, Pedrosa A, Pui CH.
Establishment of a pediatric oncology program and outcome
of childhood acute lymphoblastic leukemia in a resourcespoor
area. JAMA. 2004;291:24 71-5.
4. Viana MB, Murao M, Ramos G, Oliviera HM, de Carvalho
RI, de Bastos M, et a!. Malnutrition as prognostic factor in
lymphoblastic leukemia: a multivariate analysis. Arc Dis
Child. 1994;71:304-10.
5. Mostert S, Sitaresmi MN, Gundy CM, Sutaryo, Veerman AJ.
Influenced of sosioeconomic status on acute lymphoblastic
leukemia treatment in Indonesia. Pediatrics. 2006; 118:e 1600-6.
6. Lobato-Mendizabal E, Ruiz-Argtielles G, Marin-Lopez
A. Leukemia and nutrition: malnutrition is an adverse
prognostic factor in outcome of treatment of patients with
standard risk-acute lymphoblastic leukemia. Leuk Res.
1989; 13:899-906.
7. Gatot D, Windiastuti W. Treatment of childhood acute
lymphoblastic leukemia in Jakarta: result of modified
Indonesian Protocol. Paediatr Indones. 2006;46: 179-184.
8. Silverman LB, Gelber RD, Dalton VK, Asselin BL, Barr RD,
Clave II LA, eta!. Improved outcome for children with acute
lymphoblastic leukemia: results of Dana-Farber consortium
protocol91-0l. Am Soc Hematol. 2001;97: 1211-8.
9. Chessels JM, Hall E, Pretinence HG, Durant J, Bailey CC,
Richards SM. The impact of age on outcome in acute
lymphoblastic leukemia; MRC UKALL X and XA compared:
a report from the MRC paediatric and adult working parties.
Leukemia. 1998:12;463-73.
10. Ming KS, LiCK, Chik KW; Lam TK, Lai HD, Ng MH, et al.
Outcomes and prognostic factors of Chinese children with
acute lymphoblastic leukemia in Hong Kong: preliminary
results. Med Pediatr Oncol. 1999:32; 117-23.
11. Ishii E, Eguchi H, Matsuzaki A, Koga H, Yanai F, Kuroda H,
et al. Outcome of acute lymphoblastic leukemia in children
with AL90 regimen: impact of response to treatment and
sex difference on prognostic factors. Med Pediatr Oncol.
2001;37:10-9.
12. Pui CH, Boyett JM, Reiling MY, Harrison PL, Rivera GK,
Behm FG, et al. Sex differences in prognosis for children with
acute lymphoblastic leukemia. J Clin Oncol. 1999;17:818-23
13. Shuster JJ, Wacker P, Pullen], Humbert], LandJL, Mahoney
DH, et al. Prognostic significance of sex in childhood
B-precursor acute lymphoblastic leukemia: a Pediatric
Oncology Group study. J Clin Oncol. 1998; 16: 2854-63.
14. Ringwald-Smith K, Todd J, Liu A, Hancock M, Pui CH.
Nutritional status potential impact on survival in children
with acute lymphoblastic leukemia. J Am Diet Assoc.
1998;98: 107-9.
15. WhitlockJA, Gaynon PS. Acute lymphoblastic leukemia. In:
Greer JP, Forester JF, Lukens JN, Rodgers GM, Paraskevas F,
Glacier B, editors. Wintrobe's clinical hematology. llst ed.
Philadelphia: Williams & Wilkins, 2004; p.2143-59.
16. Gaynon PS, Siegel SE. Childhood acute lymphoblastic
leukemia. In: Henderson ES, Lister TA, Greaves MF, editors.
Leukemia. 17th ed. Philadelphia: Saunders, 2002; p.601-10.
17. Margolin JF, Steuber CP, Pop lack DG. Acute lymphoblastic
leukemia. In: Pizzo PA, Poplack DG, editors. Principles and
practice in pediatric oncology. 14th ed. Philadelphia: Williams
& Wilkins, 2002; p.489-527.
18. Waterlow ]C. Classification and definition of protein calorie
malnutrition. BMJ. 1972;3:566-9.
19. Cortes JE, Kantarjian HM. Acute lymphoblastic leukemia: a
comprehensive review with emphasis on biology and therapy.
Cancer. 1995;76:2393-402.
20. Pedrosa F, Bonilla M, Liu A, Smith K, Davis D, Ribeiro R, et
al. Effect of malnutrition at the time of diagnosis on survival
of children treated for cancer in El Salvador and Northern
Brazil. J Pediatr Oncol. 2000;22:502-5.
21. Pui CH, Sandlund JT, Pei D, Campana D, Rivera GK,
Ribeiro R, et al. Improved outcome of children with acute
lymphoblastic leukemia: results of Total Therapy Study
XIIIB at St. Jude Children's Research Hospital. Blood.
2004; 104:2690-6.
22. Van Dongen JJ, Seriu T, Panzer-Grumayer ER, Biondi A,
Pongers-Willem MJ, Corral L, et al. Prognosis value of
minimal residual disease in acute lymphoblastic leukemia in
childhood. Lancet. 1998;352: 1731-8.
23. Gomez-Almaguer D, Ruiz-Alg[ielles G, Ponce-de Leon
S. Nutritional status and socio-economic conditions as
prognostic factors in the outcome of therapy in childhood acute
lymphoblastic leukemia. IntJ Cancer. 1998;(11):52-55.
Published
2009-12-31
How to Cite
1.
Permatasari E, Windiastuti E, Satari H. Survival and prognostic factors of childhood acute lymphoblastic leukemia. PI [Internet]. 31Dec.2009 [cited 9Nov.2024];49(6):365-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/603
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Received 2016-09-12
Accepted 2016-09-12
Published 2009-12-31
Accepted 2016-09-12
Published 2009-12-31
