History of treatment and long-term outcome in children with acute lymphoblastic leukaemia in Serbia

We present the results of a retrospective study of ALL treatment from 1995 to 2002 according to the modified SR arm of ALL BFM 90 protocol in Serbia. Treatment was performed in five centres, two of them located in Belgrade, one in Nis, one in Novi Sad and one in neighbouring Republic of Srpska. Modification was necessary due to inadequate supply of medications and diagnostic reagents at the time and was mainly related to reduction of treatment intensity and the differences of patient stratification in comparison to the original BFM protocol. There were 462 patients, 188 of whom were girls (40.7%) and 274 boys (59.3%); median age was 5.5 years (range 1-17.9 years). In total, 98.4% patients achieved complete remission after induction treatment. Twenty patients (4.3%) died before achieving complete remission during induction treatment; additionally, there were 34 remission deaths (7.4%) and 88 relapses (19%). Median time of follow-up was 87.1 months. Ninety four patients (20.3%) were lost to follow-up (LFU). Five-year event-free survival (EFS) was 73.1% and 10-year EFS 70.5%.