OUTCOME OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKAEMIA AFTER INDUCTION THERAPY—3 YEARS EXPERIENCE AT A SINGLE PAEDIATRIC ONCOLOGY CENTRE

Authors

  • Zulfiqar Ali Rana
  • Muhammad Waqar Rabbani
  • Muhammad Aslam Sheikh
  • Afsheen Asghar Khan

Abstract

Background: Acute lymphoblastic leukaemia (ALL) is the most common paediatric malignancy. Itrepresents 25% of all childhood cancers and approximately 75% of all cases of childhood leukaemia.A sharp peak of ALL incidence is observed at 2–5 years of age. Objective was to see the bonemarrow remission pattern at the end of induction therapy in paediatric ALL patients in our setup. Itwas a Descriptive case series and conducted at Paediatric Oncology Department, Children Hospitalcomplex Multan from December, 2005 to December, 2008. Methods: Thirty-eight paediatric ALLpatients were included in the study. Diagnosis was based on history, examination, blast cells counton peripheral blood film and bone marrow biopsy and immunophenotyping on peripheral blood/bonemarrow aspirate. According to UK ALL 2003 protocol all patients were given 4-drug inductiontherapy, i.e., vincristine, prednisolone/dexamethasone, L-aspiragenase and daunomycin. Bonemarrow biopsy was repeated at day 28 of induction therapy and remission pattern was seen. Results:Out of 38 Patients, 26 (68%) were males. Age range was between 2–12 years (Mean 5.4 years).Bone Marrow Biopsy was done in 38 (100%) and Immunophenotyping in 34 (89%) patients. At day28 of induction therapy, 28 (74%) patients went into complete remission (<5% blast cells in bonemarrow), 2 (5%) into partial remission (5–25% blast cells in bone marrow) and 1 (3%) was not inremission (>25% blast cells in the bone marrow). Seven (18%) patient died due to febrileneutropenia and sepsis during the course of induction therapy. Conclusion: ALL in children iscurable with effective chemotherapy. Remission can be achieved in most of these patients afterinduction therapy. However outcome can be improved with effective control of infections.Keywords: Acute Lymphoblastic Leukaemia, Induction Therapy, Remission.

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Published

2009-12-01