Result of childhood acute lymphoblastic leukemia protocol (INCTR) from a developing country

Abstract

20015 Background: Acute Lymphatic Leukemia in children is a curable disease in the range of 80–90 % in developed Countries by aggressive protocol like BFM, St. Judes’. In developing Countries like ours, patients can’t tolerate those aggressive protocol because of Socio- economic and nutritional factors. The less aggressive Protocol like INCTR (International Network for Cancer Treatment & Research) are suitable in developing Countries like ours. The aim of our study was to see outcome of childhood ALL patient with INCTR protocol and tolerability of the protocol in Indian-asian population. Methods: We treated 480 Children (age range 1–25 years, median age of 11 yrs) with INCTR Protocol at Netaji Subhash Chandra Bose Cancer Research Institute, Kolkata, India, a tertiary cancer centre from Eastern India during period from April ’99 to Dec ’06. There was female preponderance in the study. Fever 283 (58.9%), lymphadenopathy 211 (43.9%) and haepatosplenomegaly 153 (31.8%) were the major clinical presentation. Forty-three (8.9%) patients were present with hyper Leukocytosis. C-ALL phenotype were the largest group though the incidence of the T-ALL were quite high (27.9%). Results: Remission induction were seen in 446 (92.9%) of the patient. In a follow-up period of 88 months (with an average of 54 months) the disease-free survival ( DFS) was 66.8% (321 patients) with an overall survival of 73.9% (355 patients). The isolated bone marrow relapse was seen in majority of the cases 40 (8.33%) and the major relapse was in maintenance and first 6 months of completion of therapy. The major cause of morbidity was infection 316 (65.8%) followed metabolic complications 81 (16.8%), hemorrhage 52 (10.8%), neurologic 10 (2.08%), hepatitis 6 (1.25%) and pancreatitis 5 (1.04%). The major cause of the mortality was infection 75%(360 patients) followed progressive disease 7.91% (38 patients) and Hemorrhage 5.83%( 28 patients). Conclusions: The data of acute lymphatic leukemia from a developing country is encouraging. The protocol was well tolerated by India- asian population. No significant financial relationships to disclose.

Neurocognitive outcomes in survivors of childhood acute lymphoblastic leukemia: Experience from a tertiary care center in India

“…All the children were managed on standard chemotherapeutic regimens used in India at the time of their diagnosis. Most of the children were treated with the International Network for Cancer Treatment and Research (INCTR) protocol, 10 and a few were treated with the ALL‐Berlin Frankfurt Munster‐95 High Risk (ALL‐BFM 95 HR) protocol, 11 labeled as protocols A and B, respectively, for the purpose of this study. All children were treated uniformly and not according to their risk.…”

Serum Adipokines as Biomarkers for Surveillance of Metabolic Syndrome in Childhood Acute Lymphoblastic Leukemia/Lymphoma Survivors in Low Middle Income Countries

“…Children with ALL were treated with various protocols including the International Network for Cancer Treatment and Research (INCTR) protocol 20 and ALL-Berlin Frankfurt Munster-95 (ALL-BFM 95) protocol 21 prior to 2017. Most children hence received chemotherapy and prophylactic CRT in their management (1260cGy and 1800cGy in the INCTR and BFM protocol, respectively).…”