Treatment strategy, progress and problems with childhood ALL: 12 year of experience at Ege University

Abstract

Between 1981 and 1993, a total of 385 children were diagnosed as acute lymphoblastlc leukemia at Ege University. There were ninety-one evaluable patients. Forty-two patients received VCR-prednisolone, from 1981 to 1986 (group I)", 29 received VCR-Prednisolone-CYC/MTX, from 1987 to 1989 (group II) and 20 were enrolled into BFM-90 protocol from 1990 to 1992 (group III). The mean age was 6.1 years at presentation; 5 (5.5%) were under 2; there were 62 boys and 29 girls with a male/female ratio of 2.13. On admission 48.2% had Hb levels lower than 7g/dl, 11.8% had leukocyte count above 50x109/L, 6 (6.6%) had central nervous system involvement and 6 (6.6%) had mediastinal Involvement. Of 91 patients, 45 (49.5%) were followed-up for more than 24 months and 38 (41.8%) died. Early relapse occurred in 32 (35.2%) patients within 6 months of treatment cessation and late relapse in 28 (30.8%) patients with an overall relapse rate of 66%. Two-year overall survival and relapse free survival rates were 45.2% and 25% for group I, 65.5% and 53.9% for group II, 73.9% and 54.2% for group III respectively, while five-year overall survival and relapse free survival rates were 31% and 15% for group I and 57.5% and 38.5% for group II respectively. Major secondary problems were hepatitis B infection comprising 33.3% and chronic active hepatitis comprising 21.2% of patients under follow up. [Turk J Cancer 1997;27(1):66-73]