Early experience in treatment of childhood acute lymphoblastic leukemia (ALL)

Abstract

OBJECTIVES: To assess the success of treatment of ALL within the constraints of a specialized unit in Sri Lanka METHODS: We analysed 51 consecutive cases of ALL presenting to a single unit within a 65 month period from 01-6-1999. (Prospective data from June 2002). Difficulties and constraints that we encountered are described. Diagnosis was made by bone marrow morphology. Treatment was with UKALL X Protocol until March 2002. Thereafter a modified MRC 99 protocol was adopted. Results: 51 children were treated and followed up for 1 month to 56 months, (average of 20 months each). There were 31 males (60%). The median age was 4.2 years. 43 children were within 2-10 year age group. Eight children had initial white cell count of more than 50 x 109/mm3. Remission was induced in 47 (92%) with induction therapy. There were no induction cTeaths. Four children (8%) were resistant to induction. Eleven children (24%) relapsed during the follow up period. Of the relapses, 9 are living with a median survival of 17 months. There were 8 deaths. There are 43 survivors at the end of study period. Based on survival analysis done by the Kaplan- Meier method, it was estimated 89, 85, and 78% of patients could survive for 1. 2 and 3 years respectively. CONCLUSIONS: We conclude that Childhood ALL could be treated safely within the setting described and early results are encouraging. (In leading centers in the developed world, probability of relapse free 5 year survival is around 80% + 8)