Abstract
Abstract only
20020
Background: The outcome of children with acute myeloid leukemia (AML) has improved over last two decades. The main factors behind this are increasing intensity of chemotherapy and improved measures of supportive care. While white blood cell count and age are major factors for risk classification in childhood acute lymphoblastic leukemia (ALL), therapy remains the single most prognostic factor. Objectives: To assess survival with each regimen of chemotherapy and causes of treatment failure. Methods: we retrospectively reviewed the details of treatment and outcome of all children with AML from 1986- 2005 (20 yr.) and ALL from 1989–2003 (15yr.) at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Results: AML 54 patients, 23 boys with median age 5 yr. (range 0.5–14 yr.). Five (9%) had CNS leukemia. Between 1986–1995, 22 pts were treated with BFM based chemotherapy, remaining 32 received UK-AML 10 between 1996–2005. 8/22 (36%) & 5/32 (16%) died of toxicity and 12 (54%) and 8 (25%) died of AML during 1
st
& 2
nd
era respectively. With a median follow up of 3 year (.5–10 yr.). The overall survival is 9% in 1
st
era and 59% in 2
nd
era. ALL 297 patients were registered. Male 165 pts., median age 5 yr. (range 1–14), WBCs >50,000x109, 55 pts. (19%). T-cell 36 (12%), pre-B 222 (75%) and 29 (10%) unknown. NCI risk classification according to age & WBCs count at presentation as HR 84 (28%), SR 204 (69%). Causes of death; 50/297 (17%) disease recurrence which failed 2
nd
line chemotherapy, 12/297 (4%) induction death and 11/297 (4%) died of toxicity. Survival by different regimens of chemotherapy were showing UKALL-X 1989–1993, 67 pts.as 55%; UKALL-XI/BFM (1994–1998) 98 pts. As 72%; MRC-97/CCG1991 (1999–2003) 132 pts.87% as overall 5 yr survival. Conclusions: This single center study confirmed that the outcome of children with AML/ALL has improved over last decade. Increasing local experience, advances in supportive care and chemotherapy have contributed to this improvement.
No significant financial relationships to disclose.