Outcomes of Low and Middle Income Children with Relapsed Acute Lymphoblastic Leukemia: Single-Center Experience

Authors : Zeliha GUZELKUCUK, Özlem ARMAN BİLİR, İkbal OK BOZKAYA, Dilek KAÇAR, Melek ISİK, Dilek GÜRLEK GÖKÇEBAY, Namık Yaşar ÖZBEK, Hüsniye Neşe YARALI

Pages : 975-981

Doi:10.16899/jcm.1345525

View : 49 | Download : 43

Publication Date : 2023-09-30

Article Type : Research Paper

Abstract :Abstract Aim: Despite numerous advances in treating acute lymphoblastic leukemia insert ignore into journalissuearticles values(ALL); in children, relapse continues to be the leading cause of mortality. This study aimed to analyze the data of patient’s characteristics, and outcomes of children with relapsed ALL. Material and Method: We retrospectively analyzed the records of patients aged 1–18 years diagnosed with relapsed ALL between January 2004 and December 2018. Results: 452 ALL patients followed up in the study period and 55 patients relapsed. The relap-se rate was 12.1%. Thirty-four insert ignore into journalissuearticles values(61.8%); of the relapsed patients were male. The median age was seven years insert ignore into journalissuearticles values(1–17 years);. Forty-six patients insert ignore into journalissuearticles values(83.6%); had precursor B-cell ALL and nine pati-ents insert ignore into journalissuearticles values(16.3%); had T-cell ALL. The site of relapse was bone marrow in 41 patients insert ignore into journalissuearticles values(74.5%);, and extramedullary insert ignore into journalissuearticles values(central nervous system, testis, or soft tissue); in 11 patients insert ignore into journalissuearticles values(20%);. The mean duration from the initial diagnosis to relapse was 32 months insert ignore into journalissuearticles values( min-max: 4 -108 months, SD±21.2); and 20 months insert ignore into journalissuearticles values(min-max: 7-38 months, SD± 11.1); in patients with B- cell ALL and T- cell ALL respectively. The median follow-up time was 39.8 months insert ignore into journalissuearticles values(min-max: 3–198 months, SD±44.5); from the initial diagnosis. Thirty-seven patients insert ignore into journalissuearticles values(67.3%); died. The 5-year overall survival rate was 41.6%. Recurrent relapse and progressive disease were the most com-mon causes of death. The mortality rate was significantly associated with the immunophenotype, treatment response on days 8, 15, and 33 of initial diagnosis, the risk group at initial diagnosis, the site of relapse, and hematopoietic stem cell transplantation insert ignore into journalissuearticles values(p<0.05);. Immunophenotype and the site of relapse were the independent variables associated with mortality. Conclusion: Relapse affects a significant portion of patients with ALL. Survival rates are still poor in patients with relapsed ALL. Also, our findings that T-cell immunophenotype and the site of relapse insert ignore into journalissuearticles values(isolated bone marrow relapse); were independent risk factors for mortality sug-gest that more specialized treatment options are needed for patients with T-ALL and bone mar-row relapse.
Keywords : Nüks, akut lenfoblastik lösemi, çocuk

ORIGINAL ARTICLE URL