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Acute lymphoblastic leukemia, the Indian scenario


MOJ Cell Science & Report
Faisal R Guru,1Javvid Muzamil,2 Shumail Bashir,3 Amita Mahajan4
Sher-i-Kashmir Institute of Medical Sciences

Abstract

Acute lymphoblastic leukemia is the most common leukemia in children. There have been advancements in management of this disease, and still research is on to improve further outcome. A prospective observational study was conducted in a tertiary care hospital in north India from 2008 till 2013, enrolled 186 pediatric acute lymphoblastic leukemia patients.

Aims: To see clinical profile of pediatric ALL patients, and to see correlation of day 8 and day 33 blast count with cytogenetic and its effect on overall survival of our patients.

Methods: It was a hospital based observational prospective study. Patients were enrolled from June 2008 till March 2010, after risk stratification, patients received risk adopted BFM 95 protocol, last patient finished his maintenance on August 2013, and study was closed in November 2013.

Results: Median age of presentation was 6.5 years and male to female ratio was 3.5:1. High risk disease was seen in 55.85% patients,Fluorescence In-Situ hybridization (FISH) for TEL AML, MLL, BCR-ABL gene rearrangements were positive in 33.3%, 9.1%, 9.7% patients respectively. Bone marrow was the commonest site of relapse. Day 8 peripheral blood blasts and day 33 bone marrow blasts had no significance as all the patients had complete clearance. So in our study the overall survival at 6 years of analysis was 86% and event free survival for the entire series was 82% at 6 years.

Keywords

overall survival efs-event free survival, acute lymphoblastic leukemia, fluorescence in-situ hybridization, cerebrospinal fluid, central nervous system, berlin-frankfurt-munster, radiotherapy, chemotherapy, febrile neutropenia, cytogenetics, biological features, chemotherapy, prognosis

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