TY - JOUR
T1 - Clinical characteristics and treatment outcome of childhood acute lymphoblastic leukemia in Saudi Arabia
T2 - A multi-institutional retrospective national collaborative study
AU - Al-Sudairy, Reem
AU - Al-Nasser, Abdullah
AU - Alsultan, Abdulrahman
AU - Ahmari, Ali Al
AU - Abosoudah, Ibraheem
AU - Al-Hayek, Reema
AU - Al-Harbi, Talal
AU - Al-Manjomi, Fahad
AU - Al-Harbi, Musa
AU - Al-Ghamdi, Hasna
AU - Al-Shahrani, Mohammed
AU - Belgaumi, Asim F.
PY - 2014/1
Y1 - 2014/1
N2 - Background: Treatment of childhood acute lymphoblastic leukemia (ALL) has been available in Saudi Arabia (SA) for over 30 years; however, only limited data have been published from there. This study was conducted to establish processes for collaborative data collection and provide clinical characteristics and outcome of children with ALL in SA. Procedure: Clinical data for patients diagnosed from 2004 to 2008 were retrospectively collected at eight institutions and entered remotely into a custom-built database. Statistics regarding clinical and genetic characteristics and treatment outcome were calculated. Results: The 594 evaluable patients had a median age of 4.37 years and 56.4% were boys. Majority of patients had B-precursor ALL while 10.7% had T-ALL. CNS leukemia was present in 5.2% of patients. The distribution of common genetic abnormalities was similar to that reported from western populations, with 24.6% hyperdiploidy, 21% RUNX1-ETV6 positivity, 4.2% BCRABL1 positivity, and 2.5% with MLL gene rearrangement. Patients received risk-adapted therapy according to various protocols, although treatment strategies for the majority were similar. Fiveyear OS, RFS and EFS were 86.9%, 79.1%, and 73.3%, respectively. The OS for patients with pre-B ALL was significantly higher than for TALL (88.0% vs. 71.8%; P=0.019, Log-Rank test). Patients with pre-B ALL categorized as low-risk by NCI/Rome criteria and those with hyperdiploidy had OS of 93.4% and 95.8%, respectively. Conclusions: The characteristics of childhood ALL in SA are similar to those observed in developed countries. Future prospective studies utilizing unified national protocols are needed to further improve the outcome of our patients.
AB - Background: Treatment of childhood acute lymphoblastic leukemia (ALL) has been available in Saudi Arabia (SA) for over 30 years; however, only limited data have been published from there. This study was conducted to establish processes for collaborative data collection and provide clinical characteristics and outcome of children with ALL in SA. Procedure: Clinical data for patients diagnosed from 2004 to 2008 were retrospectively collected at eight institutions and entered remotely into a custom-built database. Statistics regarding clinical and genetic characteristics and treatment outcome were calculated. Results: The 594 evaluable patients had a median age of 4.37 years and 56.4% were boys. Majority of patients had B-precursor ALL while 10.7% had T-ALL. CNS leukemia was present in 5.2% of patients. The distribution of common genetic abnormalities was similar to that reported from western populations, with 24.6% hyperdiploidy, 21% RUNX1-ETV6 positivity, 4.2% BCRABL1 positivity, and 2.5% with MLL gene rearrangement. Patients received risk-adapted therapy according to various protocols, although treatment strategies for the majority were similar. Fiveyear OS, RFS and EFS were 86.9%, 79.1%, and 73.3%, respectively. The OS for patients with pre-B ALL was significantly higher than for TALL (88.0% vs. 71.8%; P=0.019, Log-Rank test). Patients with pre-B ALL categorized as low-risk by NCI/Rome criteria and those with hyperdiploidy had OS of 93.4% and 95.8%, respectively. Conclusions: The characteristics of childhood ALL in SA are similar to those observed in developed countries. Future prospective studies utilizing unified national protocols are needed to further improve the outcome of our patients.
KW - Acute lymphoblastic leukemia
KW - Childhood
KW - Outcome
UR - http://www.scopus.com/inward/record.url?scp=84891699834&partnerID=8YFLogxK
U2 - 10.1002/pbc.24584
DO - 10.1002/pbc.24584
M3 - Article
C2 - 23940019
AN - SCOPUS:84891699834
SN - 1545-5009
VL - 61
SP - 74
EP - 80
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 1
ER -