Treating childhood acute lymphoblastic leukemia in a developing country 1998-2003: The experience of a single children's Hospital in China

Purpose: To assess the outcome of children with acute lymphoblastic leukemia (ALL) treating with ALL China-98 in a single children's Hospital in China. Patients and Methods: Between 1998 and June 2003, a total of 58 children in our hospital were treated according to ALL China-98. The patients were >= 1 and <= 15 years of age at diagnosis. The date of last follow-up was 31 December 2005. Results: The 5-year event-free survival (EFS) rate was 51.30% with a median observation time of 3.37 years. EFS was 63.51% in low-risk group and 46.20% in high-risk group (P = 0.025). The overall survival was 57.69%. The overall mortality from sepsis was 15.5%. Relapse occurred in 24.1% of patients. Conclusions: Compared with reports from industrialized countries, our experience with ALL China-98 protocol showed a lower remission rate, a lower 5-year EFS, and a higher mortality from sepsis. Treating ALL patients with definitively effective treatment guidelines or protocols and establishment of strategies to reduce deaths from sepsis are the priorities.