A Single Institution's Experience with Cytogenetic and MRD Outcomes in Pediatric Acute Lymphoblastic Leukemia

被引:5
作者
Amjad, Asim [1 ]
Wali, Rabia Muhammad [1 ]
Anjum, Sadia [1 ]
Mansoor, Raheela [1 ]
机构
[1] Shaukat Khanum Mem Canc Hosp, Dept Pediat Oncol, Lahore, Pakistan
来源
JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN | 2019年 / 29卷 / 06期
关键词
Cytogenetics; Acute lymphoblastic leukemia (ALL); Minimal residual disease (MRD); MINIMAL RESIDUAL DISEASE; BONE-MARROW RESPONSE; PROGNOSTIC-FACTORS; B-CELL; CHILDHOOD; CHILDREN; THERAPY; IMPACT; BFM;
D O I
10.29271/jcpsp.2019.06.549
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To determine the frequency of cytogenetic type and its significance in the prognostic outcome of the pediatric patients in acute lymphoblastic leukemia (ALL), aged 1 to 15 years, and also determine the importance of minimal residual disease (MRD) in the management of the condition. Study Design: An observational study. Place and Duration of Study: Pediatric Oncology Ward, Shaukat Khanum Cancer Hospital, Lahore, from January 2015 to July 2017. Methodology: Patients aged 1-15 years, diagnosed with ALL, were included. Studied variables were cytogenetic type and MRD outcome in patients with ALL. Patients under one year of age and more than 15 years, or those having comorbidities, were excluded. Results: Total 150 patients' data were retrieved from the Hospital database. One hundred and thirty-three belonged to age 1 to 5 years group (89%) and 17 (11%) were in 5 to 10 years group. The mean age of the patient was 4.3 +/- 3.1 years. One hundred and two (68%) were males; whereas, 48 (32%) were females. Pre B acute lymphoblastic leukemia was diagnosed in 139 (93%) patients and 11(7%) were diagnosed with Pre T acute lymphoblastic leukemia. Standard risk was observed in 120 (80%) patients and 30 (20%) patients were on high risk as per National Cancer Institute (NCI) Guidelines. Regimen A was used in 125 (83.3%), Regimen B in 16 (10.7%), and Regimen C in 9 (6%) patients. BCR-ABL was positive in 2 (1.30%), TEL-AML in 68 (45%), MLL in 5 (3.30%), and normal in 54 (36%). MRD at day 29 was negative in 40 (93%) and positive in 3 (7%). The karyotyping was done in 128 (85%) patients, out of which 68 (53%) were hyperploids, 41 (32%) euploid, and 19 (15%) were hypoploid. Death was observed in 22 (15%) patients. Nineteen (86%) deaths were due to fungal and bacterial sepsis; and disease-related deaths were noted in 3 (14%) patients. Conclusion: The role of MRD and cytogenetics in risk assessment has improved in the early prognosis determination.
引用
收藏
页码:549 / 552
页数:4
相关论文
共 21 条
[1]  
Bonig H, 2014, VLA4 ACUTE LYMPHOBLA, P637
[2]   Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children's Oncology Group study [J].
Borowitz, Michael J. ;
Devidas, Meenakshi ;
Hunger, Stephen P. ;
Bowman, W. Paul ;
Carroll, Andrew J. ;
Carroll, William L. ;
Linda, Stephen ;
Martin, Paul L. ;
Pullen, D. Jeanette ;
Viswanatha, David ;
Willman, Cheryl L. ;
Winick, Naomi ;
Camitta, Bruce M. .
BLOOD, 2008, 111 (12) :5477-5485
[3]   Minimal residual disease monitoring in childhood acute lymphoblastic leukemia [J].
Campana, Dario .
CURRENT OPINION IN HEMATOLOGY, 2012, 19 (04) :313-318
[4]   Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia [J].
Cavé, H ;
ten Bosch, JV ;
Suciu, S ;
Guidal, C ;
Waterkeyn, C ;
Otten, J ;
Bakkus, M ;
Thielemans, K ;
Grandchamp, B ;
Vilmer, E .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (09) :591-598
[5]   Molecular response to treatment redefines all prognostic factors in children and adolescents with B-cell precursor acute lymphoblastic leukemia: results in 3184 patients of the AIEOP-BFM ALL 2000 study [J].
Conter, Valentino ;
Bartram, Claus R. ;
Valsecchi, Maria Grazia ;
Schrauder, Andre ;
Panzer-Gruemayer, Renate ;
Moericke, Anja ;
Arico, Maurizio ;
Zimmermann, Martin ;
Mann, Georg ;
De Rossi, Giulio ;
Stanulla, Martin ;
Locatelli, Franco ;
Basso, Giuseppe ;
Niggli, Felix ;
Barisone, Elena ;
Henze, Guenter ;
Ludwig, Wolf-Dieter ;
Haas, Oskar A. ;
Cazzaniga, Giovanni ;
Koehler, Rolf ;
Silvestri, Daniela ;
Bradtke, Jutta ;
Parasole, Rosanna ;
Beier, Rita ;
van Dongen, Jacques J. M. ;
Biondi, Andrea ;
Schrappe, Martin .
BLOOD, 2010, 115 (16) :3206-3214
[6]   Immunological detection of minimal residual disease in children with acute lymphoblastic leukaemia [J].
Coustan-Smith, E ;
Behm, FG ;
Sanchez, J ;
Boyett, JM ;
Hancock, ML ;
Raimondi, SC ;
Rubnitz, JE ;
Rivera, GK ;
Sandlund, JT ;
Pui, CH ;
Campana, D .
LANCET, 1998, 351 (9102) :550-554
[7]   Impact of Tyrosine Kinase Inhibitors on Minimal Residual Disease and Outcome in Childhood Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia [J].
Jeha, Sima ;
Coustan-Smith, Elaine ;
Pei, Deqing ;
Sandlund, John T. ;
Rubnitz, Jeffrey E. ;
Howard, Scott C. ;
Inaba, Hiroto ;
Bhojwani, Deepa ;
Metzger, Monika L. ;
Cheng, Cheng ;
Choi, John K. ;
Jacobsen, Jeffrey ;
Shurtleff, Sheila A. ;
Raimondi, Susana ;
Ribeiro, Raul C. ;
Pui, Ching-Hon ;
Campana, Dario .
CANCER, 2014, 120 (10) :1514-1519
[8]   Prediction of outcome by early bone marrow response in childhood acute lymphoblastic leukemia treated in the ALL-BFM 95 trial: differential effects in precursor B-cell and T-cell leukemia [J].
Lauten, Melchior ;
Moericke, Anja ;
Beier, Rita ;
Zimmermann, Martin ;
Stanulla, Martin ;
Meissner, Barbara ;
Odenwald, Edelgard ;
Attarbaschi, Andishe ;
Niemeyer, Charlotte ;
Niggli, Felix ;
Riehm, Hansjoerg ;
Schrappe, Martin .
HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, 2012, 97 (07) :1048-1056
[9]  
MILLER DR, 1983, CANCER-AM CANCER SOC, V51, P1041, DOI 10.1002/1097-0142(19830315)51:6<1041::AID-CNCR2820510612>3.0.CO
[10]  
2-G