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The Outcome of Acute Lymphoblastic Leukemia in 109 Adult Iraqi Patients

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Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

While many studies addressed the outcome of adult ALL in developed Western countries, there is paucity of such prospective studies from developing Mediterranean ones. This is a prospective cohort study conducted at Hiwa Cancer Hospital in Sulaimani city and Nanakali Hospital in Erbil city-Kurdistan Iraq from March 2012 to August 2017. The main characteristics of adult ALL patients, type of therapy and risk factors were analyzed to assess their impact on treatment outcome and survival status. A total of 109 adult ALL patients were included with a median age of 24 years and male to female ratio of 1.7:1. B-ALL accounted for 76.1% of the cases, while the rest were T-ALL. BCR-ABL rearrangement was encountered in 12% of B-ALL. Complete remission (CR) rate was 81.7%, the overall 5 year survival (OS) was 38%, Relapse Free 5 year Survival (RFS) was 49%. Younger adults (< 35 years) had significantly higher CR rates and OS compared to the older group (P < 0.001 each). On the other hand, gender, high leucocyte count ≥ 50×109/L, immunophenotype (including B and T ALL subtypes), and clinical risk status did not predict a poor outcome. Multivariate analysis revealed that only age < 35 years and BCR-ABL rearrangement were significantly associated with better OS. Despite some limitations, the outcomes of Iraqi adult ALL is comparable to those reported in Western developed countries, with particularly favorable outcomes in younger patients. The need to improve outcome in adult ALL remains an important priority in our country as it is throughout the world.

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Authors and Affiliations

  1. Department of Hematology, Hewa Hemato-onology Hospital, Sulaimani, Iraq

    Dyna Jaza Mohammed

  2. Department of Pathology, College of Medicine, University of Sulaimani, Sulaimani, Iraq

    Sana Dlawar Jalal & Ali Ibrahim Mohammed

  3. Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq

    Ahmed Khudair Yassin

  4. Department of Pathology, College of Medicine, University of Duhok, Duhok, Iraq

    Nasir Abdulsalam Al-Allawi

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  1. Dyna Jaza Mohammed
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  2. Sana Dlawar Jalal
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  3. Ahmed Khudair Yassin
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  4. Ali Ibrahim Mohammed
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  5. Nasir Abdulsalam Al-Allawi
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Correspondence to Sana Dlawar Jalal.

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Mohammed, D.J., Jalal, S.D., Yassin, A.K. et al. The Outcome of Acute Lymphoblastic Leukemia in 109 Adult Iraqi Patients. Indian J Hematol Blood Transfus 37, 264–270 (2021). https://doi.org/10.1007/s12288-020-01345-1

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  • DOI: https://doi.org/10.1007/s12288-020-01345-1

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