Chemotherapy Delays Are Associated with Inferior Outcome in Acute Lymphoblastic Leukemia: A Retrospective Study from a Tertiary Cancer Center in South India

Agrawal, Vineet; Kayal, Smita; Ganesan, Prasanth; Dubashi, Biswajit

doi:10.1055/s-0041-1729513

Cited by 5 publications

(6 citation statements)

References 28 publications

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“…Compared to a study done in Egypt, 26 our diagnosis delay is comparable, but the median treatment delay is longer than studies done in Egypt, 26 Canada, 27 and India. 12 It is a challenge to compare our data with other studies regarding diagnostic delay as they defined “diagnosis delay” as the time from any first healthcare contact to cancer diagnosis; however, we defined it as the time interval to establish a diagnosis after the child has reached our cancer treatment facility. In addition, as it is a retrospective study, collecting data regarding the first healthcare contact was not possible.…”

Section: Discussionmentioning

confidence: 99%

“…A structured questionnaire was developed by reviewing similar studies [10][11][12][13] to collect the data from the patient's medical record. Trained final-year medical interns under close supervision of the principal investigator and collected data retrospectively.…”

Section: Eligibility Criteria and Data Collectionmentioning

confidence: 99%

“…There are controversies regarding the impact of delay in diagnosis and initiation of treatment on survival rate among patients treated for ALL. [10][11][12] Hence, this study aimed to describe the delay in treating children with ALL and to determine the impact on the early survival of these children. Early (induction mortality) is defined as death occurring within 42 days of initiation of induction treatment.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Delay Prior to Treatment in Ethiopian Children with Acute Lymphoblastic Leukemia

Hailu¹,

Mekasha²,

Hailu³

et al. 2023

PHMT

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Introduction More than 85% of childhood malignancies occur in developing countries with less than a 30% cure rate as opposed to more than 80% cure rate in developed countries. This disproportionately significant difference might be due to delays in diagnosis, treatment initiation, lack of adequate supportive care, and treatment abandonment. We aimed to determine the impact of overall treatment delay on induction mortality of children with acute lymphoblastic leukemia treated at Tikur Anbessa specialized hospital (TASH). Methods A cross-sectional study was conducted among children who were treated from 2016 to 2019. Children with Down syndrome and relapsed leukemia were excluded from this study. Results A total of 166 children were included; most patients were males (71.7%). The mean age at diagnosis was 5.9 years. The median time interval from the onset of symptoms to the first TASH visit was 30 days and the median period from TASH’s first clinic visit to diagnosis was 11 days. The median time to initiate chemotherapy after diagnosis was 8 days. The total median time from the first onset of symptoms to chemotherapy initiation was 53.5 days. Induction mortality was 31.3%. High-risk ALL and patients with an overall delay between 30 and 90 days were more likely to experience induction mortality. Discussion Patient and healthcare system delay is high compared to most studies done and a significant association has been noted with induction mortality. Efforts to expand the pediatric oncology service in the country and efficient diagnostic and treatment approach need to be established to reduce mortality associated with overall delay.

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Section: Discussionmentioning

confidence: 99%

Section: Eligibility Criteria and Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Delay Prior to Treatment in Ethiopian Children with Acute Lymphoblastic Leukemia

Hailu¹,

Mekasha²,

Hailu³

et al. 2023

PHMT

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“…17 Treatment delays during chemotherapy are thought to affect prognosis. 18,19 This audit shows that patients treated with the UKALL14 protocol have more delays; this is one aspect where we can potentially improve on.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes of adult acute lymphoblastic leukaemia in Auckland, New Zealand

Hemmaway,

Wong,

Offner

et al. 2023

NZMJ

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aim: Acute lymphoblastic leukaemia/lymphoma (ALL) is a rare disease that requires an intensive chemotherapy regimen for successful treatment. This is a single-centre retrospective audit to assess the treatment outcomes in the largest ALL centre in New Zealand.method: Data such as survival and adverse events of patients with de novo ALL referred to Auckland City Hospital for treatment were included in this audit. Sub-group analyses were also performed. results: Sixty-five patients aged from 18 upwards with ALL were included in this audit. The median survival of all patients was 37.6 months. Adolescent and young adults (AYA) treated on the COG (paediatric) protocols had a mean survival of 48.3 months (median not reached), while adults treated with the UKALL14 protocol had a median survival of 37.6 months. In the UKALL14 sub-group, Māori/ Pacific Islanders had an inferior EFS that was statistically significant. conclusion: Overall AYA outcomes are comparable to international standards. Our adult outcomes may be poorer than the original UKALL14 trial, with Māori/Pacific Island patients having shorter survival.

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“…The median follow-up was 41 months. [14] In another study on a group of 141 pediatric patients, the median cumulative length of delay was 39 days, while the media delay in the intensive phase was 23 days and in the maintenance phase, 12 days. [15] Interruption during chemotherapy was observed in 94.7% of patients.…”

Section: Discussionmentioning

confidence: 99%

Severe complications in the induction phase of therapy in a pediatric patient with T-cell acute lymphoblastic leukemia: A case report

Rocka,

Woźniak,

Lejman

et al. 2023

Medicine

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Rationale: Acute lymphoblastic leukemia (ALL) represents approximately 1-quarter of all new cases of childhood cancer. Although overall survival following diagnosis has improved in recent years, the toxicity of chemotherapy remains a concern. Patient concerns: We describe an 11-year-old male patient diagnosed with T-cell precursor ALL who developed compounded complications during the induction phase of chemotherapy. Patient was hospitalized in the Department of Pediatric Hematology, Oncology, and Transplantology of the Medical University of Lublin, Poland. The patient’s induction therapy was started according to the AIEOP-BFM ALL 2017 protocol IAp (International Collaborative Treatment Protocol for Children and Adolescents with Acute Lymphoblastic Leukemia). Diagnoses: Patient developed compounded complications such as cholecystitis, hepatotoxicity, pancreatitis and myelosuppression. Interventions: The patient was treated with leukapheresis, received a broad-spectrum antibiotic, potassium supplementation and hepatoprotective treatment and laparotomy cholecystectomy. Outcomes: In the available literature, there is a limited amount of similar clinical cases with multiple complications in pediatric patients with ALL. Toxicities cause delays in the treatment of the underlying disease. Lessons: In children with acute lymphoblastic leukemia, there are side effects during the treatment such as cholecystitis and pancreatitis. Complications during treatment require a quick response and modification of disease management. Abdominal ultrasound performed before treatment makes it possible to observe the dynamics of lesions. Genetic mutation analysis could allow us to more precisely respond to the possible susceptibility to and appearance of complications after the use of a given chemotherapeutic agent.

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Chemotherapy Delays Are Associated with Inferior Outcome in Acute Lymphoblastic Leukemia: A Retrospective Study from a Tertiary Cancer Center in South India

Cited by 5 publications

References 28 publications

Impact of Delay Prior to Treatment in Ethiopian Children with Acute Lymphoblastic Leukemia

Impact of Delay Prior to Treatment in Ethiopian Children with Acute Lymphoblastic Leukemia

Treatment outcomes of adult acute lymphoblastic leukaemia in Auckland, New Zealand

Severe complications in the induction phase of therapy in a pediatric patient with T-cell acute lymphoblastic leukemia: A case report

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