Hematological parameters and remission induction of childhood acute lymphoblastic leukemia

Perdani, Roro Rukmi Windi; Sudarmanto, Bambang

doi:10.14238/pi58.2.2018.71-4

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…9,10 Male predominance was found in other studies as well. 11 Fever and pallor were more prevalent (Figure 1) than other studies. 12 This may be due to delayed diagnosis and referral causing advanced presentation.…”

Section: Discussionmentioning

confidence: 74%

Time of Attainment of Clinical Remission and Peripheral Blood Count Recovery during Induction Chemotherapy for Childhood Acute Lymphoblastic Leukemia

Khatun,

Jamal,

Rahman

et al. 2023

Bangladesh Med Res Counc Bull

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Background: Acute lymphoblastic leukemia(ALL) is the most common pediatric malignancy. Infection and bleeding are the leading cause of death during induction chemotherapy in childhood ALL. So, proper knowledge about anticipated infection and bleeding are very important during this period. But the duration of clinical remission and recovery of peripheral blood count during induction chemotherapy is not well reported in literature. Objective: The aim of the study was to determine the time of attainment of clinical remission and recovery of peripheral blood count after initiation of induction chemotherapy and to determine if the duration of clinical remission and peripheral blood count recovery differs between therapeutic risk groups. Methods: This prospective observational study was conducted from January 2021 to December 2021 in the Department of Paediatric Haematology and Oncology, BSMMU. Newly diagnosed admitted Eighty-Six ALL of both sexes aged 1 to 17.9 years were included. After commencing chemotherapy, physical examination was recorded every day until clinical remission and complete blood count (CBC) was recorded one to two days interval until peripheral blood count recovery. The number of packed red blood cell (PRBC) and platelet transfusions and the number of days of intravenous antibiotics were recorded. Results: Mean duration of clinical remission, complete Hemoglobin (Hb), Absolute neutrophil count(ANC) and platelet recovery was 8.4 ± 4.5 days, 25±7.9 days, 23.3±5.6 days and 21.8±6.4 days respectively (p<0.01). Time to attain partial recovery of platelet was 14.0±4.9 days in high risk and 19.2±5.3 days in standard risk group. PRBC transfusion requirement was 2.2±1.2 units in high risk group and 1.7±0.8 units in standard risk group (p<0.05). Time to attain partial recovery of ANC, number of days with I/V antibiotics and duration of treatment interruption were higher in high risk group. Conclusion: Time of clinical remission was similar between risk group. Platelet recovery occurred earlier than Hemoglobin (Hb) and absolute neutrophil count (ANC) recovery. Transfusion and supportive care requirement were more in high risk group during induction chemotherapy. So, more supportive care should be arranged up to three weeks of induction period to increase survival of high risk childhood ALL. Bangladesh Med Res Counc Bull 2023; 49: 177-182

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Section: Discussionmentioning

confidence: 74%

Time of Attainment of Clinical Remission and Peripheral Blood Count Recovery during Induction Chemotherapy for Childhood Acute Lymphoblastic Leukemia

Khatun,

Jamal,

Rahman

et al. 2023

Bangladesh Med Res Counc Bull

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“…8 Complications from hyperleukocytosis such as hyperviscosity, and tumor lysis syndrome, may lead to bleeding, respiratory distress, and thromboembolism, thus increasing the risk of mortality. 6,9,10 We found that 84% of the high-risk status patients died, which was significantly higher than mortality in the standard-risk patients (57%). The mean survival times were 583.40 (70.75) days and 1,407.96 (139.81) days, respectively.…”

Section: Discussionmentioning

confidence: 74%

3-year survival rate in acute lymphoblastic leukemia: comparison of ALL-2006 and ALL-2013 Protocols

Meirizkia¹,

Ayu²,

Indra³

et al. 2021

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Background With advances in supportive and risk-stratified therapy, the 5-year survival rate of acute lymphoblastic leukemia has reached 85.5%. The ALL-2006 treatment protocol was modified and renamed the ALL-2013 protocol, with dose and duration changes. Objective To compare outcomes of the ALL-2006 and ALL-2013 protocols, with regards to mortality, remission, relapse, and three-year survival rates. Methods This was retrospective cohort study. Subjects were acute lymphoblastic leukemia (ALL) patients treated from 2011 to 2018 in Mohamad Hoesin Hospital, Palembang, South Sumatera. The three-year survival rates, relapse, remission rates and comparison of ALL-2006 and ALL-2013 protocols were analyzed with Kaplan-Meier method. Results Mortality was significantly correlated with age at diagnosis <1 year and >10 years, hyperleukocytosis, and high-risk disease status. Patients aged 1 to 10 years, with leukocyte count <50,000/mm3 and standard-risk status had significantly higher likelihood of achieving remission. Mortality was not significantly different between the ALL-2006 protocol group [70.6%; mean survival 1,182.15 (SD 176.89) days] and the ALL-2013 protocol group [72.1%; mean survival 764.23 (SD 63.49) days]; (P=0.209). Remission was achieved in 39.2% of the ALL-2006 group and 33% of the ALL-2013 group (P>0.05). Relapse was also not significantly different between the two groups (ALL-2006: 29.4% vs. ALL-2013: 17.9%; P>0.05). Probability of death in the ALL-2006 group was 0.3 times lower than in the ALL-2013 group (P<0.05), while that of the high-risk group was 3 times higher. Remission was 2.19 times higher in those with leukocyte <50,000/mm3 compared to those with hyperleukocytosis. In addition, relapse was significantly more likely in high-risk patients (HR 2.96; 95%CI 1.22 to 7.19). Overall, the 3-year survival rate was 33%, with 41.7% in the ALL-2006 group and 30.7% in the ALL-2013 group. Conclusion Three-year survival rate of ALL-2006 protocol is higher than that of ALL-2013 protocol but is not statistically significant. Age at diagnosis <1 year and >10 years, hyperleukocytosis, and high-risk group are significantly correlated with higher mortality and lower remission rates. However, these three factors are not significantly different in terms of relapse.

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“…Rahim P, et al 20 found the incidence of remission as high as 100% in patients with Hb levels <5 g/dl. Study by Perdani RRW, et al 21 at Kariadi Hospital on 55 paediatric patients with ALL also did not show a significant relationship between Hb levels and remission, and remissions were more common in children with anaemia. The difference in prognosis based on Hb levels is thought to be because the lower Hb levels (Hb <8g /dl) are more frequently found in types of leukaemia with better outcomes (TEL/AML1, hyperdiploidy).…”

Section: Discussionmentioning

confidence: 84%

“…This study showed the remissions tended to occur in patients with platelet counts >30,000/cu mm and this was statistically significant. Perdani RRW, et al 21 performed a study on 55 patients with ALL showing that as many as 56% of patients had thrombocytopenia (<150,000/cu mm) and this was significantly associated with a lower remission rate than normal platelet levels or thrombocytosis. It can be seen that there are differences in the platelet cutoffs used in different studies, thus allowing for differences in results.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors affecting remissions based on minimal residual disease (MRD) examination in paediatric acute lymphoblastic leukaemia patients after induction phase treatment

Yuliastini

Ariawati

Utama

et al. 2023

Sri Lanka J Child Health

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Introduction: Acute lymphoblastic leukaemia (ALL) is the commonest cancer in children. Remission in the induction phase plays an important role in prognosis. Minimal residual disease (MRD) examination can detect cancer cell residues not detectable by conventional morphological methods.Objectives: To identify prognostic factors affecting ALL remissions at the end of the induction phase of chemotherapy treatment using MRD examination as the paediatric gold standard.Method: This is a retrospective cohort study. Fortysix children diagnosed with ALL aged 1 to 18 years in the paediatric ward of Sanglah General Hospital, Bali, Indonesia were enrolled in this study from 2017 to 2019. Data with categorical variables were analysed using the Chi-Square test. A p-value <0.05 was considered statistically significant.Results: A total of 46 subjects, aged 1 to 10 years, was included in this study. Twenty-five (54.3%) patients experienced relapse, 21 (45.7%) of them achieving remission by MRD examination at the end of the induction phase. Bivariate test results showed a significant difference in therapeutic response based on L1 type (p = 0.028) and platelet levels (p = 0.017). Multivariate test results showed a platelet level >30,000/ cu mm caused remission in ALL patients p=0.013). The L1 type was significantly associated with treatment response (95% CI 0.013-0.617, p = 0.014).

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Hematological parameters and remission induction of childhood acute lymphoblastic leukemia

Cited by 7 publications

References 12 publications

Time of Attainment of Clinical Remission and Peripheral Blood Count Recovery during Induction Chemotherapy for Childhood Acute Lymphoblastic Leukemia

Time of Attainment of Clinical Remission and Peripheral Blood Count Recovery during Induction Chemotherapy for Childhood Acute Lymphoblastic Leukemia

3-year survival rate in acute lymphoblastic leukemia: comparison of ALL-2006 and ALL-2013 Protocols

Prognostic factors affecting remissions based on minimal residual disease (MRD) examination in paediatric acute lymphoblastic leukaemia patients after induction phase treatment

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