Background: Hue Central Hospital (HCH) plays a key role to treat Acute Lymphoblastic Leukemia (ALL) in the central zone of Vietnam which covers geographically wide areas. Before 2007, the survival rate was very low, and abandonment rate was more than 50%. The aims of this study are to determine the outcome of newly diagnosed children with ALL treated at HCH from June 2007 to December 2017 and to report our experiences in reducing the abandonment.Methods: This is a retrospective review of 238 children with ALL admitted from June 2007 to December 2017. The diagnosis was confirmed by morphological FAB criteria and cytochemistry. Patients were classified as standard risk (SR) or high risk (HR) according to NCI criteria, using modified-CCG-1881 and CCG-1882 protocol. Social supports were provided to patients/families.Results: A total of 238 children with ALL were analyzed with mean age of 4.7 years ranging from 1 month to 16 years. The male to female ratio was 2:1. SR and HR patients were 139 (59%) and 99 (41%) respectively. The overall complete remission (CR) rate on day 28 of induction were 92.1% (SR) and 84.9% (HR). Induction death were 3.6% (SR) and 10.1% (HR). Patients accounted for 44 (18.5%) had relapses which occurred in isolated BM n=12, isolated CNS n=17, combined BM and CNS n=13, isolated testis n=2. Overall survival (OS) at 10 years were 70.7% (SR) and 51.5% (HR). The event-free survival (EFS) at 10 years were 66.1%(SR) and 47.3%(HR). Abandonment cases were 9 (3.8%). Conclusion:With less toxic modified protocol, survival rate has been improved and treatment related mortality was minimized though high relapse rate is still an issue. Abandonment has been reduced successfully with holistic strategies such as financial support, managing family group, providing education, early follow-up of patients who missed appointments and free accommodation near hospital for patients/families.

SUMMARY: Four Vietnamese infants who survived infection with Salmonella meningitis are reported. A female infant who experienced relapse recovered without complications and another had neurological sequellae. The remaining 2 infants survived without complications. The initial treatment was chloramphenicol and ceftriaxone, whereas a change of antibiotics to imipenem and fluoroquinolone was required for 2 infants. Fluoroquinolone may be a treatment option in patients with Salmonella meningitis who experience complications even though the drug is contraindicated for the pediatric age group.