Outcome of children with acute lymphoblastic leukemia treated without cranial irradiation at National Cancer Institute, Egypt / Mohamed Magdy Mahmoud ; Supervised Iman Abdelmokhales Sidhom , Amr Abdalla Salem , Omnia Kamal Elgebaly

Thesis (M.Sc.) - Cairo University - National Cancer Institute - Department of Pediatric Oncology

This retrospective study included children between 1 and 18 years of age with confirmed diagnosis of acute lymphoblastic leukemia who started treatment at the National Cancer Institute, Cairo University during the period from 1st January 2010 to 31st December 2012 and they were followed up till the end of September 2016. B-cell precursor phenotype was encountered in 78.6% ofpatients, T-cell in 21.4%. According to study XV of SJCRH criteria for risk classification, 38.5% of patients were in the low risk group and 61.5% were in the standard/high risk group. At the end of the induction phase, 49 patients (26.9%) died and the remaining 133 patients (73.1%) achieved remission. The 5 years overall survival and event free survival for all 182 patients were 52% and 51.6% respectively, while the 5 years disease free survival for evaluable 133 patients at end of inducation was 72.3%. In the current study, 9 patients had initially CNS III status, only one of them had isolated CNS relapse and none of these patients received cranial irradiation as first line. In this study, we had 10 CNS relapses out of 133 evaluable patients at end of induction (7.52%), 8 were isolated CNS relapse, while 2 were combined CNS and medullary relapse. As for for prognostic factors for any CNS relapse, risk stratification was the only significant variable. The commulative incidence of any CNS relapse was 0.8%, 5.8%, 8% and 10% at 1,2,3 and 5 years respectively while the commulative incidence of isolated CNS relapse was 0.8%, 4.9%, 7% and 8.9% at 1,2,3 and 5 years respectively

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