Outcomes With Risk-stratified Treatment Algorithm for Childhood ALL in India

Risk-stratified management with reduced-treatment intensity for standard-risk (SR) patients is an effective strategy. With treatment-related mortality (TRM) continuing to be a major concern in low-middle-income countries, it is vital to limit treatment for patients with favorable disease. We report analysis of 410 consecutive ALL patients from our center treated employing a risk-stratified, response-adapted algorithm. At a median of 8 years from diagnosis, 5-year OS and EFS for the entire cohort and SR group are 84.1%, 81.9%, 91.6%, and 88.5%, respectively. The induction TRM was 1.7% (none in the SR group) reaffirming its efficacy in our setting with relatively limited resources.