Clinical characteristics and outcome of pediatric patients diagnosed with acute lymphoblastic leukemia over 6 years’ period, single institute experience (Children Welfare Teaching Hospital)

Abstract: BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common diagnosed malignancy in children, representing nearly 1/4 of all cancers seen in the age group of 0–14 years, worldwide the survival of ALL has increased tremendously over the last four decades. OBJECTIVES: The objective of this study was to study the clinical characteristics and outcome of pediatric patients diagnosed with ALL (intermediate and high risk), treated with two different protocols over 6 years’ period. MATERIALS AND METHODS: A retrospective analytic study carried out over 6-years in the period from January 1, 2017 to December 31, 2022, on 586 newly diagnosed pediatric patients with ALL. Two hundred and fifty-seven cases were excluded from the study. All the demographic data, disease characteristics, diagnosis, treatment, its complications, and outcome were taken from electronic archived files, or patients personal files. Two protocols adapted in the period of the study (UKALL 2011 andUKALL 2019) with modifications adapted to our own setting. RESULTS: Of 329 patients, male was predominant in 205 (62.3%). Out of 329 patients who received prephase steroid, 186 (56.5%) were good responders, 125 (38%) were poor responders with a significant P = 0.03. Induction remission was reported in 296 patients (90%), induction failure in 18 patients (5.5%), induction death was reported in 15 patients (4.6%). Five-year overall survival of both groups of patients was (54.9%), 5-years event free survival (EFS) was (52.2%). CONCLUSIONS: Steroid responsiveness and initial white blood cell count at diagnosis are considered to be a good prognostic factor. High-dose methotrexate (MTX)-based protocol showed better results in regard to OS and EFS rates than Capizzi style-MTX style protocol, in Group C patients.