Improved Outcomes of Childhood Acute Lymphoblastic Leukemia: A Retrospective Single Center Study in Saudi Arabia

Abstract

Objective: Understanding the clinical and genetic characteristics of pediatric acute lymphoblastic leukemia (ALL)<br /> patients may help assigning the appropriate treatment. This study aims to understand patients' characteristics, “real-world"<br /> treatment practice and outcomes of pediatric ALL. Methods: A cohort of 213 pediatric ALL patients, treated at (King<br /> Faisal Specialist Hospital and Research Center –Jeddah branch) KFSH and RC-J during the period of January 2002 to<br /> December 2015 were analyzed retrospectively. Statistical analyses were performed on patients' demographic, clinical<br /> and genetics characteristics and outcomes of different treatment protocols. Survival was evaluated using Kaplan-Meier<br /> method, and differences in survival were tested using Log-Rank. Significance was set at 0.05 level. Results: Median<br /> age of the study cohort was 5 years (range 0.5–15 years) with 55.4% of male population. Majority of the patients had<br /> pre-B-cell ALL (88.7%), WBC count <50, 000/μL at diagnosis (76.1%, median = 13.5/μL with a range of 0.51–553.0/<br /> μL) with involvement of central nervous system (CNS) disease in 8.5%patients.Different common chromosomal<br /> anomalies or abnormalities, including t(12, 21) translocation, MLL genre arrangements, trisomy (4, 10, 17)and others,<br /> were detected. Early response to the risk-directed treatment received by the patients (91.1% achieving <5% blast in<br /> the bone marrow) as well as the end of induction outcome (96.2%) was encouraging. Conclusion: We found that the<br /> patients' clinical characteristics and distribution of genetic abnormalities were similar to those of the western countries.<br /> Our findings show that the earlier gap between the western countries and KSA in terms of survival has been closed and<br /> that competitive outcomes can be achieved with local infrastructure.