Publication: 3-year survival rate and prognostic factors of acute lymphoblastic leukaemia among paediatric patients on ukall protocol in Hospital Universiti Sains Malaysia
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Date
2022
Authors
Ishak, Hasdalina
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Abstract
Background: Paediatric patients with acute lymphoblastic leukaemia have shown better overall survival and event-free survival over the recent decades. This outcome is due to the advancement of diagnostic modalities, individualised patient treatment and improved supportive care. This study was done to determine common clinical presentations, the known prognostic factors associated with disease outcomes and the overall survival in paediatric ALL patients treated with UKALL protocol. Methods: This was a retrospective cohort study involving data interpretation from medical records of children diagnosed with ALL and received treatment with UKALL protocol in Hospital Universiti Sains Malaysia from 1st January 2008 until 31st December 2018. Kaplan-Meier analysis with log-rank test was performed to determine the 3-year survival probability. Multivariate analysis with simple and multiple Cox regression was performed to determine the significant prognostic factors of poor disease outcome. Results: A total of 97 patients were included in the study. The commonest clinical presentations were fever (83.5%), pallor (82.5%) and lethargy (52.6%). Clinical examinations also revealed that most patients had hepatomegaly (92.8%), splenomegaly (83.5%) and lymphadenopathy (82.5%). The 3-year OS is 72.2%. In this study, the Kaplan -Meier analysis showed that the weight percentile (p=0.002) and CSF involvement (p=0.023) were significant factors in leukaemia patients' survival. Multivariate analysis showed that the weight percentile of the 10th – 95th percentile significantly predicted the poor survival outcome (p=0.002). Conclusion: Most paediatric ALL patients usually present with common clinical presentations of acute leukaemia. Our overall survival is considered fair and comparable to other developing countries
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Keywords
acute lymphoblastic leukaemia , overall survival