engleski

Improved therapeutic outcome in children with acute lymphoblastic leukemia in Croatia

Therapeutic outcome in children with acute lymphoblastic leukemia (ALL) has greatly improved with more intensive chemotherapy, risk adapted strategies and better supportive care. Aim was analysis of therapeutic results recorded by the National Group for Pediatric Hematology in children with ALL in Croatia treated with pediatric trial ALL IC-BFM 2002. Patients and methods: From November 1, 2002 until November 2, 2010, 208 ALL children i.e. 119 (58%) male and 89 (42%) female, mean age 75.4 months, were treated according to ALL IC-BFM 2002 protocol: SRG – 74 (35.5%) ; IRG -104 (50.6%) ; and HRG -30 (13.9%), at four Croatian pediatric hematology-oncology centers: Zagreb University Hospital Center 145 (69.7%) ; Split University Hospital – 30 (14.4%) ; Rijeka University Hospital Center – 17 (8.2%) ; Zagreb University Children’s Hospital S.Milosrdnice – 16 (7.7%). The first complete remission (CR) was achieved in 208(100.0%) patients, whereas relapse occured in 23(11.2%), hematologic relapse (BM) in 17(8.2%), meningeal relapse (CNS) in 3(1.4%), hematologic and meningeal relapse (BM and CNS) in 2 (0.97%) and hematologic and testicular relapse (BM and TR) in 1(0.48%). 2 (0.9%) patients dropped out from our records. 16(7.6%) of 206 patients died: 3(1.4%)in the first complete remission, 2(0.9%) after bone marrow transplantation and 11 (5.3%) in relapse. 190(92%) patients have survived to the present ; 72(97.7%) from SRG, 97(91.8%) in IRG and 21(64.7%) from HRG. Secondary tumor disease was not recorded. The 4-year event free survival (EFS) was 88% ; overall free survival (OFS) was 89%. These results were nearly identical to those reported from the leading European centers for the treatment children with ALL. All authors have declared no conflicts of interest.

acute lymphoblastic leukemia; treatment; adolescents; Croatia

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