Outcome of childhood acute lymphoblastic leukemia treatment in a single center in Brazil: A survival analysis study

Cancer Rep (Hoboken). 2022 Jan;5(1):e1452. doi: 10.1002/cnr2.1452. Epub 2021 Jun 11.

Abstract

Background: Acute lymphoblastic leukemia (ALL) is the most common neoplasm in childhood. The probability of current overall survival (OS) is around 90% in developed countries. There are few studies that demonstrate the results in Brazil.

Aim: This work aims to analyze the results of children with ALL treated at a single institution in Rio de Janeiro.

Methods and results: Retrospective analysis survival study of a cohort of childhood ALL patients treated in Hemorio. Kaplan-Meier and log-rank methods were used for the analysis of OS and events-free survival (EFS) and the Cox proportional hazards regression model for multivariate analysis. The probability of OS and EFS at 6 years was 52% and 45%. The probability of OS and EFS in 6 years for patients aged 10-17 years was 31% and 28% and for the younger was 65% and 55%, respectively (p < .001). A probability of OS and EFS in 6 years for patients with more than 100 000 leukocytes/mm3 at diagnosis was 19% and 16% and those with less than 100 000 were 62% (p = .007) and 55% (p = .008). Those who received less than 10 doses of native Escherichia coli asparaginase had a probability of OS and EFS in 6 years of 27% and 21% and those who received at least 10 doses were 74% and 65% (p < .001).

Conclusions: The presence of a high number of adolescents and high-risk patients, as well as many patients who discontinued the use of asparaginase or any substitute led to a lower probability of OS and EFS in our cohort.

Keywords: AYA; acute lymphoblastic leukemia; asparaginase; pediatrics; prognostic factors.

MeSH terms

  • Adolescent
  • Antineoplastic Agents / therapeutic use
  • Asparaginase / therapeutic use
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Disease-Free Survival
  • Female
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / epidemiology*
  • Progression-Free Survival
  • Proportional Hazards Models
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Asparaginase