RESPONSE RATE OF PAKISTANI CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKAEMIA TO MEDICAL RESEARCH COUNCIL ACUTE LYMPHOBLASTIC LEUKAEMIA 97 CHEMOTHERAPY PROTOCOL

Authors

  • Muhammad Idris
  • Jamila Farid
  • Javed Sarwar
  • Suhaib Ahmed
  • Muhammad Amin Wiqar
  • Shahida Badsha

Abstract

Background: Acute lymphoblastic leukaemia (ALL), a malignancy of lymphoid lineage cells, hasexcellent prognosis in children. In Pakistan, a few studies highlighted the response of ALL tochemotherapy. The Present study was planned to see the response rate of Pakistani children with ALLto Medical Research Council ALL 97 (MRCALL97) chemotherapy protocol. This descriptive caseseries was conducted at the Department of Haematology, Armed Forces Institute of Pathology and theDepartment of Paediatric Oncology, Combined Military Hospital, Rawalpindi from 16th of February2007 to 16th of August 2007. Methods: Diagnosed children with ALL fulfilling the inclusion criteriawere interviewed regarding history of the present, past illnesses, and family history. Physicalexamination was performed. Presenting clinical features, blood counts and blood and bone marrowblasts percentage were used to see the response on day 29 post chemotherapy. The data was recordedon a structured proforma for statistical analysis. Results: A total of 33 patients were studied including26 males and 7 females. Twenty-five patients belonged to age group 2–9 years, and 8 to <2 or >9 years,median age being 4.5 years. Presenting WBC count was <50×109/L in 30 patients and >50×109/L in 3patients. At the end of induction, complete remission was achieved in 31 out of 33 (94%) patients whiletwo patients did not achieve remission. Conclusion: Response rate of Pakistani children with ALL tochemotherapy was superior to the previously reported figures from Pakistan.Keywords: Acute Lymphoblastic Leukaemia, ALL, remission, chemotherapy

References

Ross JA, Davies SM, Potter JD, Robison LL. Epidemiology of

childhood leukemia, with a focus on infants. Epidemiol Rev

;16:243–72.

Asif MJ, Iqbal Z, Malik A, Hayee A. Trends in childhood acute

leukaemia: Six year experience at Shaikh Zayed Hospital Lahore.

Pak Paed J 2000;24:43–9.

Zahid M, Khalid A, Ahmed Z D, Aziz, Z. Acute leukemias of

childhood: a retrospective analysis of 62 cases. J Pak Med Assoc

;46:147–9.

Ikram N, Hassan K, Ramzan M, Tufail S, Bukhari K. Leukemias

in children. J Pak Inst Med Sci 2003;14;728–34.

J Ayub Med Coll Abbottabad 2010;22(3)

http://www.ayubmed.edu.pk/JAMC/PAST/22-3/Idris.pdf 11

Khawaja MR, Allana SS, Akbarali AN, Adil SN, Khurshid M,

Pervez S. Flow cytometric and demographic analysis of T cell

acute Lymphoblastic Leukemia in Pakistani population. J Ayub

Med Coll Abbottabad 2005;17:3–8.

Hirt A, Antic V, Wang E, Lüthy AR, Leibundgut K, von der

Weid N, et al. Acute lymphoblastic leukaemia in childhood: cell

proliferation without rest. Br J Haematol 1997;96:366–8.

Hoelzer D, Gale RP. Acute lymphoblastic leukaemia in adults:

recent progress, future directions. Semin Hematol 1987;24:27–39.

Cooke JV. Incidence of acute leukaemia in children. JAMA

;119:547–50.

Hasle H. Pattern of malignant disorders in individuals with

Down's syndrome. Lancet Oncol 2001;2:429–36.

Hasle H, Clemmensen IH, Mikkelsen M. Risks of leukaemia and

solid tumours in individuals with Down’s syndrome. Lancet

;355:165–9.

Steinherz PG, Gaynon PS, Breneman JC, Cherlow JM,

Grossman NJ, Kersey JH, et al. Cytoreduction and prognosis in

acute lymphoblastic leukemia-the importance of early marrow

response: report from the Children Cancer Group. J Clin Oncol

;4:389–98.

van Dongen JJ, Seriu T, Panzer-Grümayer ER, Biondi A,

Pongers-Willemse MJ, Corral L, et al. Prognostic value of

minimal residual disease in acute lymphoblastic leukaemia in

childhood. Lancet 1998;352:1731–8.

Harani MS, Adil SN, Kakepoto GN, Khilji Z, Shaikh U,

Khurshid M. Significance of cytogenetic abnormalities in acute

myeloid Leukemia. J Pak Med Assoc 2006;56:9–13.

Khan AR, Sheikh MH, Intekhab K. Does weight for age have

prognostic significance in children with Acute Lymphoblastic

Leukemia? Pak J Med Sci 2006;22:167–70.

Khan AR, Sheikh MH, Intekhab K. Effect of hypoproteinemia on

treatment outcome in children with acute Lymphoblastic

Leukemia. J Ayub Med Coll Abbottabad 2006;18:53–6.

Anwar M, Ayyub M, Iqbal H. Frequency of Cytogenetic

abnormalities in patients of acute Myeloid Leukemia. Pakistan J

Pathol 2006;17:25–8.

Tahir M, Anwar M, Raziq F. Utility of immunological marker

CD14 in identifying monocytic component in acute Leukemia. J

Postgrad Med Inst 2004;18:553–7.

Idris M, Shah S H, Fareed J, Nasreen G. An experience with

sixty cases of hematological malignancies; a clinico

hematological correlation. J Ayub Med Coll Abbottabad

;16:51–4.

Qazi RA, Ramzan M. Prognostic factors in Acute Lymphoblastic

Leukemia in adults. J Pak Inst Med Sci 2003;14:720–4.

Ansari SH, Irfan M, Farzana T, Panjwani VK, Shamsi TS. Invivo purging with the anti-CD20 antibody Rituximab along with

standard allogeneic peripheral blood stem cell transplantation

(PBSCT) for relapsed childhood pre - B acute lymphoblastic

leukemia (ALL). J Coll Physicians Surg Pak 2006;16:67–8.

Hashmi KU, Khan B, Ahmed P, Raza S, Hussain I, Ahsan A, et al.

FLAG-IDA in the treatment of refractory/relapsed acute

Leukemias: Single centre study. J Pak Med Assoc 2005;55:234–8.

Kakepoto GN, Burney IA, Zaki S, Adil SN, Khurshid M. Longterm outcomes of acute myeloid leukemia in adults in Pakistan. J

Pak Med Assoc 2002;52:482–6.

Mahmood R, Maqbool S. Management of patients with acute

Lymphoblastic Leukemia comparison and outcome with two

protocols-UKALL-X and modified BFM. Pak J Pathol

;11:79–83.

Zafar L, Zafar T, Anwar M, Siddiqui SA, Badshah S, Saleem M.

Response to different chemotherapy regimens in childhood acute

lymphoblastic leukaemia: a pilot study. J Coll Physicians Surg

;7:89–91.

Kamps WA, Bokkerink JP, Hakvoort-Cammel FG, Veerman

AJ, Weening RS, van Wering ER, et al. BFM-oriented treatment

for children with acute lymphoblastic leukemia without cranial

irradiation and treatment reduction for standard risk patients:

(ALL): analysis of the GIMEMA 0496 protocol. Blood

;105:3434–41.

Vilmer E, Suciu S, Ferster A, Bertrand Y, Cavé H, Thyss A, et

al. Long-term results of three randomized trials (58831, 58832,

in childhood acute lymphoblastic leukemia: a

CLCGEORTC report. Leukemia 2000;14:2257–66.

Downloads

Published

2010-09-01

Most read articles by the same author(s)

1 2 3 > >>