loading page

Treatment outcomes in childhood acute lymphoblastic leukemia: 40-year experience from a single tertiary center in Thailand
  • +2
  • Shevachut Chavananon,
  • Pornpun Sripornsawan,
  • Natsaruth Songthawee,
  • Edward McNeil,
  • Thirachit Chotsampancharoen
Shevachut Chavananon
Prince of Songkla University Faculty of Medicine
Author Profile
Pornpun Sripornsawan
Prince of Songkla University Faculty of Medicine
Author Profile
Natsaruth Songthawee
Prince of Songkla University Faculty of Medicine
Author Profile
Edward McNeil
Prince of Songkla University Faculty of Medicine Epidemiology Unit
Author Profile
Thirachit Chotsampancharoen
Prince of Songkla University Faculty of Medicine
Author Profile

Abstract

Background. Studies on the long-term treatment outcomes of childhood acute lymphoblastic leukemia (ALL) in resource-limited countries are scarce. The purpose of this study was to assess the evolution of survival outcomes of pediatric ALL in a tertiary care center in Thailand over a 40-year period. Patients and methods. We retrospectively reviewed the medical records of pediatric patients who were diagnosed with ALL and treated at our center between June 1979 and December 2019. We classified the patients into 4 study periods depending on the therapy protocol used to treat the patients (period 1: 1979-1986, period 2: 1987-2005, period 3: 2006-2013, and period 4: 2014-2019). The Kaplan Meier method was used to determine overall and event-free survival for each group. The log-rank test was used to identify statistical differences. Results. Over the study period, 726 patients with ALL were identified, 428 boys (59%) and 298 girls (41%), with a median age at diagnosis of 4.7 years (range: 0.2–15 years). The study periods 1, 2, 3, and 4 had 5-year event-free survival (EFS) rates of 27.6%, 41.6%, 55.9% and 66.4%, and 5-year overall survival (OS) rates of 32.8%, 47.8%, 61.5%, and 69.3%, respectively. From period 1 to period 4, both the EFS and OS rates increased significantly (p<0.0001). Age, study period, and white blood cell (WBC) count were all significant prognostic indicators for survival outcomes. Conclusions. The overall survival of patients with ALL treated in our center improved significantly over time from 32.8% in period 1 to 69.3% in period 4.