Improved outcomes in children with acute lymphoblastic leukemia treated with modified BFM protocols: a single-center experience

Authors : İbrahim Bayram, Gülay Sezgin, Ayşe Özkan, Serhan Küpeli, Atila Tanyel, i

Pages : 506-518

Doi:10.17826/cumj.1559123

View : 75 | Download : 148

Publication Date : 2025-06-30

Article Type : Research Paper

Abstract :Abstract Purpose: We compared the treatment protocols used for acute lymphoblastic leukemia (ALL) patients admitted to our clinic between January 1990 and September 2021. Materials and Methods: Patient files were retrospectively reviewed. Data collection was finalized in June 2022. Patients were divided into three groups based on treatment protocols. Group I (n=234) received BFM-85, -90, or -95 protocols between 1990 and January 2001. Group II (n=139) received a modified BFM-95 protocol (TRALL-2000) between January 2001 and March 2007. Group III (n=199) received a center-modified TRALL-2000 protocol starting in 2007. Results: Of the patients, 344 (60.1%) were boys and 228 (39.9%) were girls. The 10-year overall survival (OS) rates were 30%, 53%, and 73% for Groups I, II, and III, respectively. Event-free survival (EFS) rates were 27%, 40%, and 64%. In Group III, the 10-year OS was 92% for the standard-risk group (SRG), 71% for the medium-risk group (MRG), and 59% for the high-risk group (HRG); the corresponding EFS rates were 72%, 68%, and 49%. Among Group III patients, the 10-year OS was 64% for girls and 78% for boys. The OS for B-cell ALL was 71%, and for T-cell ALL, 78%. Conclusion: OS and EFS rates in Group III were significantly higher than in earlier groups. Contrary to existing literature, T-cell ALL patients and male patients in Group III had superior outcomes compared to B-cell ALL patients and female patients.
Keywords : Akut lenfoblastik lösemi, çocukluk çağı, kemoterapi, BFM protokolleri

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