Childhood T-lineage acute lymphoblastic leukemia: Management and outcome at a tertiary care center in North India
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
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.
- Pui CH, Evans WE. Treatment of acute lymphoblastic leukemia. N Engl J Med. 2006;354:166–778. CrossRef
- Vrooman LM, Silverman LB. Childhood acute lymphoblastic leukemia: update on prognostic factors. Curr Opin Pediatr. 2009;21:1–8. CrossRef
- Uckun FM, Sensel MG, Sun L, Steinherz PG, Trigg ME, Heerema NA, et al. Biology and treatment of childhood Tlineage acute lyphoblastic leukemia. Blood. 1998;91:735–746.
- Heerema NA, Sather HN, Sensel MG, Kraft P, Nachman JB, Steinherz G, et al. Frequency and clinical significance of cytogenetic abnormality in pediatric T-Lineage acute lyphoblastic leukemia: A Report from the children’s Cancer Group. J Clin Oncol. 1998;16:1270–1278.
- Shanta V, Mitreyan V, Sagar TG, Gajalakshmi CK, Rajalekshmy KR. Prognostic variables and survival in pediatric acute lyphoblastic leukemias; cancer institute experience. Pediatr Hematol Oncol. 1996;13:205–216. CrossRef
- Rajalekshmy KR, Abitha AR, Premila R, Gnanasagar T, Maitreyan V, Shanta V. Immunophenotyping of acute lyphoblastic leukemia in Madras, India. Leuk Res. 1994;18:183–190. CrossRef
- Bhargava M, Kumar R, Karak A, Kochupillai V, Arya LS, Mohanakumar T. lmmunological subtypes of acute lymphoblastic leukemia in North India. Leuk Res. 1988;12:673–678. CrossRef
- Magrath IT, Shanta V, Advani S, Adde M, Arya LS, Banavali S, et al. Treatment of acute lymphoblastic leukemia in countries with limited resources; lessons from a use of single protocol in India over a twenty years period. Eur J Cancer. 2005;41:1570–1583. CrossRef
- Rajalekshmy KR, Abitha AR, Pramila R, Gnanasagar T, Shanta V. Immunophenotypic analysis of T-cell acute lyphoblastic leukemia in Madras, India. Leuk Res. 1997;21:119–124. CrossRef
- Kamel AM, Assem MM, Jaffer ES, Magrath MI, Dneen A, Hindway DS. Immunological phenotypic pattern of acute lymphoblastic leukemia in Egypt. Leuk. 1989;13:519–525. CrossRef
- Ramot B, Magrath IT. The environment is a major determinant of the immunological subtype of lymphoma and acute lymphoblastic leukemia in children. Br J Haemat. 1982;50:183. CrossRef
- Naeem S, Hayee A. Acute lymphoblastic leukemia-a study of immunophenotypes. J Pak Med Ass. 1992;42:83–86.
- Salzer WL, Devidas M, Carroll WL, Winick N, Pullen J, Hunger SP, et al. Long-term results of the Pediatric Oncology Group studies for childhood acute lymphoblastic leukemia 1984–2001: a report from the Children’s Oncology Group. Leukemia. 2009 Dec 17 [Epub ahead of print].
- Gaynon PS, Angiolillo AL, Carroll WL, Nachman JB, Trigg ME, Sather HN, et al. Long-term results of the Children’s Cancer Group studies for Childhood acute lymphoblastic leukemia 1983–2002: A Children’s Oncology Group Report. Leukemia. 2009 Dec 17 [Epub ahead of print].
- Pui CH, Pei D, Sandlund JT, Ribeiro RC, Rubnitz JE, Raimondi SC, et al. Long-term results of St Jude Total Therapy Studies 11, 12, 13A, 13B, and 14 for childhood acute lymphoblastic leukemia. Leukemia. 2009 Dec 17 [Epub ahead of print].
- Kamps WA, van der Pal-de Bruin KM, Veerman AJ, Fiocco M, Bierings M, Pieters R. Long-term results of Dutch Childhood Oncology Group studies for children with acute lymphoblastic leukemia from 1984 to 2004. Leukemia. 2009 Dec 17 [Epub ahead of print].
- Goldberg JM, Silverman LB, Lewy DE, Dalton VK, Gelber RD, Lehman L et al. Childhood T-cell acute lymphoblastic leukemia: The Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium experience. J Clin Oncol. 2003;21:3618–3622. CrossRef
- Advani SH, Kamat DM, Rao DN, Gopal R, Nair CN, Saikia T. T cell acute lymphoblastic leukemia: a report of 60 patients from India. Oncology. 1985;42:282–286. CrossRef
- Advani SH, Pai S, Venzon D, Adde M, Kurkure PK, Nair CN, et al. Acute lymphoblastic leukemia in India: An analysis of prognostic factors using a single treatment regimen. Ann Oncol. 1999;10:167–199. CrossRef
- Uckum FM, Reaman G, Steinherz PG, Arthur DC, Sather H, Trigg M, et al. Improved clinical outcome for children with T-Lineage acute lyphoblastic leukemia after contemporary chemotherapy: A Children’s Cancer Group study. Leukemia Lymphoma. 1996;24:57–70. CrossRef
- Paes CA, Viana MB, Freire RV, Martins-Filho OA, Taboada DC, Rocha VG. Direct association of socioeconomic status with T-cell acute lymphoblastic leukemia in children. Leuk Res. 2003;27:789–794. CrossRef
- Viana MB, Fernandes RAF, Oliveria BM, Murao M, de Andrade Paes C, Duarte AA, et al. Nutritional and socioeconomic status in the prognosis of childhood acute lymphoblastic leukemia. Haematologica. 2001;86:113–120.
- Kulkarni KP, Marwaha RK, Trehan A, Bansal D. Survival outcome in childhood ALL: experience from a tertiary care centre in North India. Pediatr Blood Cancer. 2009;53:168–173. CrossRef
- Pullen DJ, Shuster JJ, Link M, Borowitz M, Amlyon M, Carroll AJ, et al. Significance of commonly used prognostic factors differs for children with T cell acute lymphoblastic leukemia (ALL), as compared to those with B-precursor ALL. A Pediatric Oncology Group (POG) study. Leukemia. 1999;13:1696–1707. CrossRef
- Dakka N, Bellaoui H, Bouzid N, Khattab M, Bakri Y, Benjouad A. CD10 and CD34 expression in childhood acute lymphoblastic leukemia in Morocco: clinical relevance and outcome. Pediatr Hematol Oncol. 2009;26:216–231. CrossRef
- Uckun FM, Gaynon PS, Sensel MG, Nachman J, Trigg ME, Steinherz PG, et al. Clinical features and treatment outcome of childhood T-Lineage acute lymphoblastic leukemia according to the apparent maturational stage of TLineage leukemia blasts: A Children’s Cancer Group Study. J Clin Oncol. 1997;15:2214–2221.
- Childhood T-lineage acute lymphoblastic leukemia: Management and outcome at a tertiary care center in North India
Volume 48, Issue 10 , pp 785-790
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Acute lymphoblastic leukemia
- Author Affiliations
- 1. Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
- 2. Pediatric Oncology & Hematology, Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi, 110 076, India