TY - JOUR ID - TI - Effectiveness of Modified UKALL protocols in Children with Acute AU - Hasanein H. Ghali PY - 2014 VL - 13 IS - 2 SP - 53 EP - 60 JO - Mustansiriya Medical Journal مجلة المستنصرية الطبية SN - 20701128 22274081 AB - Background:Acute Lymphoblastic Leukaemia (ALL) is the most common diagnosisin childhood cancer. Cure is possible and even likely. Aims of study: To evaluatethe effectiveness of modified UKALL protocols in a setting with limited resourcesand to define an event free survival of Acute Lymphoblastic Leukemia in childrenaged 1 ‐15 years who were committed to finish treatment.Methods: This is a retrospective study that reviewed 559 children with newlydiagnosed ALL between 1 and 15 years of age during the period: January 1st, 2000to December 31st, 2009 who were committed to finish treatment protocol. Allpatients were treated with regimens modified from Medical Research Councilprotocol (United Kingdom Acute Lymphoblastic Leukemia‐ UKALL‐ protocols).The Event Free Survival (EFS) was measured using Kaplan – Meier method with atotal duration of observation till December 31st 2011 (a minimum of two years poststarting treatment) and data were processed and tabulated using SPSS (StatisticalPackage for the Social Sciences) .Results:The majority of treated children (348, 62.2%) were standard risk group;remission induction was achieved in 461(82.4%) patients. Eleven patients (1.9%)were poor responders. Death during first 60 days from treatment was reported in87 (15.5%) patients and death in complete remission (CR) was reported in 49 (8.7%)patients. The major presumptive causes of death were infection/sepsis followedby bleeding. Of 559 patients; 302(54%) remained in continuous complete remissionwith a median follow up time of 52.5 months (range from 23.9 months‐ 11.6 years).There was a significant difference in EFS between Standard Risk group (61.2%) andHigh Risk group (42.2%) after induction (P=0.02) and in later phases of therapy(P=0.0002). Increased relapse rate in high risk group was the reason behind thedifference in EFS (P=0.0004) between two groups. Relapses were documented in110(19.6%) patients and the bone marrow (51.8%) was the main site of relapsefollowed by CNS (27.2%).Conclusion:The study showed lower ALL EFS than that of recognized cancercenters.

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