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Vaskina et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract36
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Relapses of acute lymphoblastic leukemia in children

Elena A. Vaskina, Tamara P. Zagoskina, Olga M. Tselousova, Elena V. Danilova

FGI “Kirov Institute of Hematology and Blood Transfusion of FMBA of Russia”, Kirov, Russia

Correspondence: Elena A. Vaskina, FGI “Kirov Institute of Hematology and Blood Transfusion of FMBA of Russia”, 72, Krasnoarmeiskaya str., 610027, Kirov, Russia, E-mail: marinanii@spam is badyandex.ru

Abstract

Introduction: 158 patients with newly diagnosed ALL were monitored in the children's hematology department of the Kirov Institute of Hematology and Blood Transfusion in the period from 1991 to 2009. Thirty-four children (21%) experienced relapses at different stages of observation.

Patient characteristics and results: The age of patients ranged from 2 to 18 years (median 7.5 years), and the ratio of girls and boys was 12/22. Fourteen (41%) of the relapses were classified as very early, 5 (14.7%) as early, and 15 (4%) as late. The structure of recurrences was as follows: isolated bone marrow relapse, 23 cases, combined, 4, and isolated extramedullary, 7. In the first acute period 24 (70%) patients were treated with the ALL–BFM-90 protocol, 5 (14.7%) with ALL–MB-2002, and 5 (14.7%) with other protocols. Anti-recurrence therapy was conducted in 30 patients; the remaining four did not receive treatment due to parent refusal. Twenty-two patients were treated with the ALL-REZ–BFM-90 protocol, 4 patients with ALL-REZ–BFM-2002, 13 patients with American protocol–3, and 1 patient with the Heltser protocol. The second complete remission (PR) was obtained in 60% of cases (18 patients). A refractory result to therapy was recorded in 3 (10%), patients with early relapse. Nine (30%) patients died of various complications and progression of the disease before reaching remission. Of the 18 patients with the second PR, 1 patient died of various complications during remission, 8 developed a second relapse (3 patients are alive in one-third complete remission, and a third relapse was recorded in 1 patient, which ended lethally). Eleven (36%) patients are in long remission.

Conclusion: The overall survival of children with recurrent ALL at their 18-year follow-up was 0.28 ± 0.09, with a median observation time of 52 months.

Keywords: children, acute lymphoblastic leukemia, relapse, treatment, survival

 

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