Acute leukemia in children: A review of the current Indian data

Abstract

Acute leukemias are the most common diagnostic group of childhood cancer. This review summarizes the published literature on reported current outcomes of childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) from India. Overall survival in ALL ranged from 45% to 81% (commonly >60%) and event-free survival ranged from 41% to 70% (commonly >50%). Outcome data for AML was patchy with varying duration of follow-up, but it can be inferred that 50–80% of treated patients had experienced an event (toxic death, refractory disease or relapse). It is imperative that going forward focus should be on collaborative efforts, which promote treatment of patients on risk-stratified adapted protocols based on local infrastructure, improvement in supportive care and encourage prospective multi-center clinical trials.

Cyclin dependent kinase inhibitor 2A/B gene deletions are markers of poor prognosis in Indian children with acute lymphoblastic leukemia

“…Acute lymphoblastic leukemia (ALL) is the commonest leukemia in children, with overall survival ranging from 45% to 81% in India and upto 90% in high income countries . ALL is known to be associated with copy number alterations in multiple genes representing roles in lymphoid development and differentiation (e.g., PAX5, IKZF1, EBF1 , and LMO2 ), cell‐cycle regulation, and tumor suppression ( cyclin dependent kinase inhibitor 2A/B [ CDKN2A/B ] , PTEN , and RB1 ) .…”

Impact of financial support and focussed group counselling on treatment abandonment in children with acute lymphoblastic leukaemia. Experience over 22 years from North India

“…Gross disparities in survival rates exists between high‐income and low‐middle‐income countries (LMIC), with rates exceeding 80% in high‐income countries while being dismally low in LMICs. Treatment abandonment is a chief contributor to this survival gap in LMICs, apart from other factors like advanced disease at presentation, late referrals, greater treatment‐related mortality, and higher rate of relapse . Another important yet often overlooked cause is the disparities that exist between the health care infrastructure of these two categories of countries regarding effective paediatric cancer care .…”

“…In India, treatment abandonment rates in acute leukaemia vary from 15% to 29% in most of the tertiary care centers, except in few centers of excellence (<10%) . This implies that, of the estimated 40 000 to 50 000 annual new childhood cancer cases in India, a majority would be deprived of adequate treatment and might eventually succumb to death.…”

Leukemia Image Segmentation Using a Hybrid Histogram-Based Soft Covering Rough K-Means Clustering Algorithm

“…As per the National Cancer Institute (NCI) statistics, in the United States, it is expected that there will be 62,130 persons as new cases for cancer treatment and 245,000 cases that are fatal or very serious [1]. In India, leukemia stands at ninth position among diseases (tumors) among children [2,3]. Leukemia is identified into two broad categories such as acute and chronic.…”