Outcomes and prognostic factors of Chinese children with acute lymphoblastic leukemia in Hong Kong: Preliminary results

Shing, Matthew Ming Kong; Li, Chi Kong; Chik, Ki Wai; Lam, Tai Kwan; Lai, Hsin‐Cheng; Ng, Margaret H.L.; Cheung, Albert Y.; Yuen, Pong Mo

doi:10.1002/(sici)1096-911x(199902)32:2<117::aid-mpo9>3.0.co;2-9

Cited by 7 publications

(7 citation statements)

References 13 publications

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“…The estimated 5‐year OS and EFS in our study were inferior compared to the cure rates reported from the developed countries 26, 27, 29, 35, 38–40. These results could be attributed to the several fold higher number of toxic deaths, higher relapse rates and poor nutritional status.…”

Section: Discussioncontrasting

confidence: 85%

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Survival outcome in childhood ALL: Experience from a tertiary care centre in North India

Kulkarni

Marwaha

Trehan

et al. 2009

Pediatric Blood & Cancer

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The management of ALL requires financial resources and access to quality supportive care. One third of our patients opted for no therapy. The other problem areas were a high proportion of therapy defaulters, lost to follow up and infection related deaths during induction and remission phases. The introduction of remedial measures for resolving the difficulties identified would hopefully improve cure rates in ALL in developing nations.

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Section: Discussioncontrasting

confidence: 85%

“…In our study context, age was not a significant prognostic factor although in log rank analysis it reached significance. In contrast, investigators in Hong Kong, South Africa and USA have identified age as an important prognostic factor 26, 37, 38.…”

Section: Discussionmentioning

confidence: 91%

Survival outcome in childhood ALL: Experience from a tertiary care centre in North India

Kulkarni

Marwaha

Trehan

et al. 2009

Pediatric Blood & Cancer

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“…This outcome data provided reasonably good result for SRG patients who were treated with less intensive chemotherapy for developing world like Indonesia with limited resources. [2][3][4][5] Nevertheless, the survival of our patients is lower than that reported by other developing countries which adopt protocol from developed centres using intensive chemotherapy. 6,7 Complete remission in SRG after…”

Section: Discussioncontrasting

confidence: 61%

Treatment of childhood acute lymphoblastic leukemia in Jakarta: Result of modified Indonesian National Protocol 94

Gatot¹,

Windiastuti²

2016

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Background Before 1990, the survival rates of childhood acutelymphoblastic leukemia (ALL) patients remained low. In 1994, theHematology Oncology Working Group of the Indonesian PediatricAssociation constructed a national protocol based on standard in-ternational protocol. As the outcome was still not promising, in 1998the protocol was modified by introducing low dose MTX infusion forCNS prophylaxis.Objective To analyze the survival of pediatric ALL patient treated withthe modified protocol in Cipto Mangunkusumo Hospital, Jakarta.Methods A prospective study was carried out to all newly diag-nosed and relapsed children with ALL from January 1998 throughDecember 2004. Patients were stratified into standard risk group(SRG) and high risk group (HRG). HRG met with one of thesecriteria: WBC >50 000/ìl, the presence of CNS involvement, medi-astinal mass, relapse, or L 3 morphology. After completing induc-tion therapy, all patients received low-dose MTX (LDMTX) infusion(500 mg/m 2 ), especially for those aged less than 3 years. If thepatient could not afford LDMTX, cranial irradiation (CRT) was given.Results There were 309 patients, consisted of 190 SRG and 119 HRGpatients. Male to female ratio was 1.8:1. Complete remission wasachieved in 86.3% SRG patients compared with 63.8% in HRG pa-tients (P<0.05). Event-free survival (EFS) rate in SRG and HRG were65.9% (95%CI 59.8; 71.9%) and 40.4% (95%CI 32.5; 48.4%), respec-tively. The overall survival (OS) rates in SRG was 81.2% (95%CI 76.3;86.2%) and in HRG was 56.0% (95%CI 47.8; 64.2%). The overall OSand EFS for both groups were 71.6% (95%CI 67.0; 76.2%) and 59.6%(95%CI 54.5; 64.7%), respectively. Failure of therapy was mostly dueto severe aplasia resulted in bleeding and severe infection. CNS re-lapse was rare in both groups, i.e. 3.1% in SRG and 0.8% in HRG.Conclusion Treatment of ALL using modified national protocol forSRG shows promising results. However, the outcome of HRG pa-tients is still inferior to those reported elsewhere. The use of low-dose MTX infusion can replace the role of cranial irradiation asCNS prophylaxis measure.

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“…In 1985, Hong Kong started applying the modified protocol of the British MRC UKALL protocol X [23]. The treatment outcomes obtained were comparable to those of the original protocol.…”

Section: Discussionmentioning

confidence: 96%

Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

et al. 2012

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With modern risk-adapted therapy, over 80% of children with acute lymphoblastic leukemia (ALL) in highincome countries (HICs) are cured. In countries with limited resources, however, therapy results for pediatric ALL are still not encouraging. We describe our experience in treating children with ALL using a risk-adapted protocol at a tertiary referral center in Lebanon. From May 2002 to August 2009, 111 consecutive patients 1-21 years of age with newly diagnosed ALL received the CCCL ALL protocol which was based on the St. Jude Children's Research Hospital Total XV Study. The median age at diagnosis was 5 years 5 months. The male to female ratio was 1.5. Forty-six patients received the intermediate-/high-risk arm and 65 received the low-risk arm. Only one patient (0.9%) died during induction therapy. Relapse occurred in 8 (7.2%) patients. Eight (7.2%) patients died, 4 of whom were in remission. The median follow-up of the patients was 38 months. The 5-year overall survival and event-free survival were and 88.5% (95% CI: 77.1-94.4) and 78.7% (95% CI: 69.8-88.4), respectively. Our results are comparable to those in HICs in spite of the limited resources and the relatively low socioeconomic status of the Lebanese population. Children treated on this protocol experienced significant toxicity necessitating expert supportive care, but benefited from improved cure rates and prolonged survival. Am. J. Hematol. 87:678-683, 2012. V

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Outcomes and prognostic factors of Chinese children with acute lymphoblastic leukemia in Hong Kong: Preliminary results

Cited by 7 publications

References 13 publications

Survival outcome in childhood ALL: Experience from a tertiary care centre in North India

Survival outcome in childhood ALL: Experience from a tertiary care centre in North India

Treatment of childhood acute lymphoblastic leukemia in Jakarta: Result of modified Indonesian National Protocol 94

Implementation of an intensive risk‐stratified treatment protocol for children and adolescents with acute lymphoblastic leukemia in Lebanon

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