Abstract
Background: There is a paucity of data on the outcome following the treatment for acute lymphoblastic
leukemia (ALL) from developing countries. Materials and Methods: Two hundred and thirty-eight consecutive patients with ALL <30 years of age diagnosed
between January 2005 and December 2011 were analyzed retrospectively. Patients were
treated modified Berlin, Frankfurt, and Munster 95 protocol. Event-free survival (EFS)
was calculated using Kaplan-Meier survival analysis and variables were compared using
log-rank test. Results: The EFS was 63.4% at a median follow-up was 32.7 months. On univariate analysis National
Cancer Institute (NCI) risk stratification, sex, white blood cell count, day 8 blast
clearance, and income were significantly associated with EFS. However, on multivariate
analysis only female sex (P = 0.01) and day 8 blast clearance (P = 0.006) were significantly associated with EFS. Seventy-four of 238 (31%) patients
had recurrent leukemia. The common sites of relapse were bone marrow in 55/74 (75%)
patients and central nervous system in 11/74 (20%) patients. Conclusion: Compared to western data, there was an increased proportion of NCI high-risk patients
and T-cell immunophenotype in our study. There has been an improvement in outcome
of patients with ALL at our center over the last 2 decades. Female sex and clearance
of blast in peripheral blood by day 8 of induction was associated with better EFS.
Keywords
Acute lymphoblastic leukemia - chemotherapy - survival
