Childhood T-lineage acute lymphoblastic leukemia: Management and outcome at a tertiary care center in North India
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- Arya, L.S., Padmanjali, K.S., Sazawal, S. et al. Indian Pediatr (2011) 48: 785. doi:10.1007/s13312-011-0129-3
To assess the clinical features, prognostic factors and outcome of childhood T-ALL in comparison with B-lineage ALL, treated with a uniform treatment regimen (MCP 841).
Pediatric oncology division of a tertiary care institution in Northern India.
Retrospective analysis of clinical data and survival outcome.
60 children with T-ALL and 139 with Blineage ALL, and less than 15 years of age treated over 15 years.
T-ALL was observed in 30%. High risk features at presentation (age ≥10 years, WBC >50,000/mm3, mediastinal mass, and CNS leukemia) were significantly more frequent in T-ALL as compared to B-lineage ALL (P=0.049, P<0.001, P<0.001 and P=0.02, respectively). Fifty five of 60 T-ALL patients (91.7%) achieved complete remission after induction therapy. There were 3 induction and 10 remission deaths while 11 (18.3%) relapsed. The overall survival and event-free survival of T-lineage ALL (61.5±7.6 and 49.9±7.4, respectively) were similar to that of B-lineage patients (68.7±4.7 and 47.1±5.1, respectively). National Cancer Institute risk groups emerged as significant prognostic factor for event free survival only in B-lineage patients.
Even though high risk features were significantly more frequent in T-ALL, survival outcome was similar to that of B-lineage patients. None of the routinely described prognostic parameters significantly impacted survival.