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

Background: Acute lymphoblastic leukemia (ALL) is the most common malignant disease in children. The most common cause of treatment failure in pediatric ALL remains relapse; it occurs in approximately 15%- 20% of patients. Current approaches for treating relapsed ALL share many similarities to frontline treatment. Despite these approaches, the overall survival (OS) rates for relapsed ALL remain low highlighting the need for alternative therapy. Aim of work: To detect pattern of relapse and treatment outcome of relapsed ALL-in children who started their first line treatment at National Cancer Institute (NCI) during the period from January 2012 till December 2015,& to determine different prognostic factors that attribute to relapse . Patients & methods: This retrospective study evaluated the pattern and outcome of all pediatric patients >1 year and <18 years with confirmed diagnosis of acute lymphoblastic leukemia (ALL) who had relapse, who received initial treatment at Pediatric Oncology Department, National Cancer Institute (NCI), Cairo University, Egypt. Data obtained from case records of 277 patients were analyzed. Information regarding demographic profile, symptoms, clinical manifestations, investigations, diagnosis, treatment, and outcome were recorded. Physical examination and Laboratory investigations at initial diagnosis were collected. Risk stratification was assessed Results: The study included 277 patients, Relapse occurred in 21.8% of them and the majority of relapsed patients experienced {u2018}early{u2019} relapses. Male predominance was found in both relapsing and non-relapsing groups with no statistically significant differences between both groups as regards sex distribution. On the other hand, statistically significant differences were found between relapsing and non-relapsing groups as regards CNS status, initial TLC, risk stratification

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