Abstract
Abstract only
9038
Background: Infants with ALL have a worse prognosis than older children. Several regimens has been used with a 4 years event free survival ranging from 25%-40%. An international collaborative treatment protocol (Interfant 99) based on the understanding of the biology of infant ALL was introduced aiming to improve the outcome and study the role of allogeneic bone marrow transplantation (BMT). To review the clinical features, treatment outcome and causes of treatment failure of all infant ALL treated at our center. Methods: We retrospectively reviewed all case notes of children with ALL diagnosed between 1986–2005 to identify infants <12 months with ALL. The age, WBC and CNS disease at diagnosis were reviewed. Treatment details and survival were studied. Results: Among 351 patients with ALL, 12 were infants (4.2%). Patients charachteristics are shown in table below. Six were boys and 6 were < 6 month at diagnosis. Nine patients (75%) had WBC count >100,000 and 4/12 CNS disease at presentation. Immunophenotyping showing lacking CD10 7/12, biphentyping 3/12, unknown 2/12 and t (4:11) found in 2/12. Treatment consisted of UKALL-based in 7 patients and Interfant 99 protocol in 5. Two patients received BMT, one from unrelated donor and the other with one antigen mismatch from his mother. Six patients (50%) died of toxicity and 3(25%) of recurrent leukemia including one who had unrelated donor BMT. Three patients survive in full remission including one who had BMT from his mother. Conclusions: This small single center study confirms the inferior outcome of infant ALL. Toxic death remains a major cause of treatment failure. Because of the rarity of infant ALL, international collaboration is required to study the role of different chemotherapy regimens and assess the role of allogeneic BMT.
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No significant financial relationships to disclose.