Retrospective analysis of demographic and clinical characteristics and treatment outcomes of pediatric acute lymphoblastic leukemia patients

Abstract

Aim: This study aimed to compare treatment outcomes (mortality and relapse) between two pediatric acute lymphoblastic leukemia (ALL) protocols (TR-ALL BFM 2000 vs ALL-IC-BFM 2009) and to describe the demographic, clinical, and laboratory characteristics of patients treated at a single center (2010–2015).

Methods: We retrospectively reviewed the medical records of 121 children (<18 years) diagnosed with ALL and treated with either TR-ALL BFM 2000 or ALL-IC-BFM 2009. Baseline characteristics, risk group, immunophenotype, protocol, relapse status, and survival status were recorded. Categorical variables were compared using the chi-square test or Fisher’s exact test, as appropriate
(p < 0.05).

Results: The cohort was 53.7% male, with a mean age at diagnosis of 7.55 ± 3.89 years. B-cell ALL accounted for 78.5% and T-cell ALL for 21.5%. The overall mortality rate was 11.6% (14/121), and relapse occurred in 5.8% (7/121) of patients. Mortality differed by risk group (SRG 6.5%, IRG 7.3%, HRG 23.5%; p = 0.036). Relapse was higher in T-cell ALL than in B-cell ALL (23.1% vs 1.1%; p = 0.001). Compared with ALL-IC-BFM 2009, TR-ALL BFM 2000 was associated with higher mortality (19.2% vs 5.8%; p = 0.022) and relapse (11.5% vs 1.4%; p = 0.019).

Conclusion: In this single-center retrospective cohort study, the high-risk group was associated with higher mortality, and the T-cell immunophenotype was associated with higher relapse. Patients treated with ALL-IC-BFM 2009 had lower crude mortality and relapse rates than those treated with TR-ALL BFM 2000; however, these protocol comparisons should be interpreted cautiously, given potential confounding and limited event numbers.