Causes of Death in Childhood Acute Lymphoblastic Leukemia at Hue Central Hospital for 10 Years (2008-2018)

Abstract

Aim. To analyze the common cause of death in childhood acute lymphoblastic leukemia patients. Methods and Materials. A retrospective descriptive study on children with acute lymphoblastic leukemia who died at Hue Central Hospital between 2008 and 2018. All the patients were treated with the same protocol of modified Children’s Cancer Group 1882 and 1881. Results. A total of 238 children with acute lymphoblastic leukemia who were cared for at our center were enrolled. Of these, there were 74 deaths. Among the death group, the male-to-female ratio was 2.7:1. Twenty-six (35.1%) occurred in maintenance phase, 18 (24.3%) occurred in induction phase, and 9 (12.2%) occurred in delayed intensification. Infection was responsible for deaths in 32 of 74 (43.2%) cases. Pseudomonas aeruginosa was found in 3 of 32 infected cases (9.4%) and resistance to almost all antibiotics in our hospital. Relapse, abandonment, and bleeding were documented in 20 (27.0%), 7 (9.5%), and 6 (8.1%) cases, respectively. Twenty-seven (84.3%) patients had absolute neutrophil count <500/µL. Of 32 infectious deaths, pneumonia occurred in 40.6%. Regarding 20 relapse death, bone marrow was the major site of relapse and it occurred in 13 (65%) cases. And there were 65% patients with very early relapse. Conclusions. Infection is the major cause of mortality in acute lymphoblastic leukemia patients in our study. To improve outcome, we should improve supportive care, especially prevention and control infection.

Childhood acute lymphoblastic leukemia: Four years evaluation of protocols 2013 and 2016 in a single center in Indonesia, a lower‐middle‐income country

“…Similar with other studies in LMICs, 3,4,9,26–29 infection was the major cause of death apart from relapse, both in ALL2013 and ALL2016. The option of antibiotic prophylaxis has been considered during induction chemotherapy 21 .…”

High prevalence and dependence of centrosome clustering in mesenchymal tumors and leukemia

“…It is clear by now that CC is an essential mechanism for chromosome instability, which contributes, between other malignant features such as drug resistance, to a high risk of tumor recurrence (Ganem et al , 2009; Holland & Cleveland, 2009; Krämer et al , 2011; Pannu et al , 2015b; Fan et al , 2021). Targeting CC might prevent the major cause of mortality in leukemia patients after infection, which is their relapse (Kiem Hao et al , 2020).…”

Treatment-Related Mortality in Children with Acute Lymphoblastic Leukaemia at a Tertiary Care Hospital of Multan

“…The study highlights the importance of infection prevention and control in the management of childhood ALL, as well as the need for early detection and appropriate management of complications to improve outcomes in children with ALL. 15 Samra et al, reviewed the evolving therapy of adult acute lymphoblastic leukemia (ALL) and highlights the latest developments in treatment, including the use of immunotherapy and targeted therapies. The study suggests that the future of ALL treatment is likely to involve more personalized and targeted approaches based on genetic and molecular profiling, as well as the use of novel agents and combination therapies to improve patient outcomes.…”