|
KMID : 0387820170240020101
|
|
Clinical Pediatric Hematology-Oncology
2017 Volume.24 No. 2 p.101 ~ p.106
|
|
|
A Multicenter Retrospective Analysis on the Treatment Pattern and Outcome in Relapsed/Refractory Childhood Acute Lymphoblastic Leukemia
|
|
Yoo Keon-Hee
Chung Nack-Gyun
Cho Bin
Kang Hyoung-Jin
Shin Hee-Young
Im Ho-Joon
Seo Jong-Jin
Lim Young-Tak
Lyu Chuhl-Joo
Kim Soon-Ki
Jeon In-Cheol
Kook Hoon
Koo Hong-Hoe
|
|
|
Abstract
|
|
|
Background: Although the overall survival of childhood acute lymphoblastic leukemia (ALL) approaches 85-90%, the prognosis of relapsed or refractory (R/R) ALL is grave. This study aimed to identify the treatment pattern, treatment response, and overall survival of these patients.
Methods: We reviewed data of 64 patients with R/R ALL whose initial diagnosis of ALL had been made between 1 and 21 years of age. Patients who received clofarabine as part of an induction regimen were excluded. Relapsed patients were limited to those who relapsed after ≥2 prior induction regimens. Treatment patterns, response rates, and overall survival were analyzed.
Results: Patients’ median age was 15.0 years (range, 6.0-25.0) at the diagnosis of R/R ALL. The most frequently used agents other than steroid were vincristine (54.0%), cytarabine (44.6%), and idarubicin (36.5%), while L-asparaginase was used in only one patient. The complete remission (CR) and overall response (OR) rates were 38.1 and 42.9%, respectively. Sixteen patients (25.4%) underwent allogeneic hematopoietic stem cell transplantation (HSCT). The 5-year overall survival was 6.7%. The survival of patients with HSCT was significantly higher compared with those without HSCT (35.2% vs 0%, P=0.0097). Among 14 patients who achieved CR or CR without platelet recovery (CRp) before HSCT, the 3-year survival was 46.9%.
Conclusion: The survival of Korean patients with R/R childhood ALL was dismal despite a reasonable CR rate, whereas that of those who received HSCT after CR or CRp was excellent. More treatment options are needed to improve the overall outcome of R/R childhood ALL.
|
|
|
KEYWORD
|
|
|
Childhood, Acute lymphoblastic leukemia, Relapsed, Refractory
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|
|