A Comparison of Two Chemotherapeutic Regimes in Children with B-Cell Acute Lymphoblastic Leukemia

Abstract

Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in childhood, and B-cell is the most common type of ALL. In childhood ALL, the most important prognostic factor is treatment and without effective treatment, ALL is a fatal illness. So far, different treatment protocols are employed for ALL chemotherapy. Each of these treatment protocols has different side effects and prognosis. Methods: In the current study, the children oncology group (COG) protocol was compared with the modified protocols, based on the Berlin-Frankfurt-Munster (BFM) protocol, called the Mofid Children’s Hospital protocol (MCHP). The current study was conducted on 108 patients; 51 patients with COG protocol and 57 with MCHP; 61.1% of patients had pre B-cell ALL type and 38.9% had early pre B-cell ALL type. Results: Induction failures in the COG and MCHP groups were 5.9% and 10.5%, respectively (P = 0.390). In the two groups, the most common recurrence sites were bone marrow (BM) and central nervous system (CNS). Moreover, the incidence of recurrence was significantly higher in the MCHP group than the COG (P = 0.262). In terms of complications, bleeding was significantly higher in the COG group than the MCHPs (P = 0.016). There was no significant difference in mortality rate between the two groups (P = 0.489). Conclusions: Comparison between treatment results of these two protocols can lead to finding a better treatment protocol to treat ALL.