Acute Complications and Survival Analysis of Childhood Acute Lymphoblastic Leukemia: A 15-year Experience

The present study evaluated the acute complications and survival rates of childhood acute lymphoblastic leukemia. We assessed 110 patients treated with the Children's Oncology Group protocol from 1999 to 2014. Childhood acute lymphoblastic leukemia, although categorized as a curable malignancy owing to the improvements in treatment strategies in recent years, can cause acute complications affecting various systems. Background: We evaluated the acute complications that occurred during the treatment of childhood acute lymphoblastic leukemia (ALL) and documented the survival rates of children with ALL. Materials and Methods: We retrospectively evaluated 110 children with a diagnosis of ALL treated with the Children's Oncology Group protocol from 1999 to 2014. The demographic, clinical, and laboratory data of 110 patients and acute complications of eligible and evaluable 105 patients were recorded. Results: Of the 110 patients, 65 were male and 45 were female. The mean age at admission was 8.3 +/- 5.2 years. Ninety-seven patients (88.2%) had been diagnosed with pre-B-cell ALL 11 (10%) with T-cell ALL, 1 (0.9%) with mixed phenotype acute leukemia, and 1 (0.9%) with mature B-cell acute leukemia Of the 110 patients, 40 (36.3%) were in the standard-risk group and 70 (63.7%) were in high-risk group. Of the 110 patients, 105 had been followed up regularly and evaluated for acute complications. Infection was the most common complication (n = 93; 88.5%), followed by gastrointestinal (n = 29; 27.6%), neurologic (n = 28; 26.6%), metabolic/ endocrine (n = 16; 15.2%), drug-related hypersensitivity (n = 16; 15.2%), avascular necrosis (n = 13; 12.3%), thrombotic (n = 11; 10.4%), severe psychiatric (n = 2; 1.9%), and various other (n = 12; 11.4%) complications. Of the 110 patients, 98 were assessed in terms of survival analysis. The 5- and 10-year overall survival rates were both 85.9% (standard error [SE], 3.6%). The relapse-free survival rates at 1, 3, and 5 years were 97.9% (SE, 1.5%), 91.3% (SE, 3%), and 86.3% (SE, 3.7%), respectively. Conclusion: Childhood ALL, although categorized as curable malignancy owing to the improvements in treatment strategies in recent years, can cause acute complications affecting various systems. Thus, patients should be treated and followed up by multidisciplinary medical teams with high expertise. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

The study evaluated the acute complications and survival rates of childhood acute lymphoblastic leukemia in 110 patients treated with the Children's Oncology Group protocol. The most common complication was infection, followed by gastrointestinal, neurologic, metabolic/endocrine, drug-related hypersensitivity, avascular necrosis, thrombotic, severe psychiatric, and various other complications. The 5- and 10-year overall survival rates were both 85.9%, with relapse-free survival rates at 1, 3, and 5 years being 97.9%, 91.3%, and 86.3%, respectively.