Abstract
Introduction: Acute lymphoblastic leukemia (ALL) is a malignancy of the white blood cells and lymphoid lines of hematopoietic cells in the blood and bone marrow while lymphomas mostly involve the lymph nodes. This study showed the response rate of ALL treated with BFM (Berlin-Frankfurt-Munster) 76/79 protocol.
 Aims & Objectives: To study the effects of WBC (White Blood Cells), age, and treatment protocols on the survival of ALL patients to BFM 76/79 protocol and other chemotherapy protocol.
 Place and duration of study: 6 months retrospective study on 2015-2017 indoor patient data from INMOL Hospital Lahore, Pakistan.
 Material & Methods: Data of 129 patients was assessed for eligibility, and 84 patients of ALL selected. Clinical information of patients regarding Gender, Age, WBC, Fever, Hepatosplenomegaly, Lymphadenopathy, Bleeding, Bone Pain, Immunophenotype, Relapse, Death, and survival rates were recorded. Patients were grouped according to Age, WBC, Gender, and Immunophenotype. Patients were treated with BFM 76/79 Protocols and the remaining patients were treated with other protocols (CALGB, FLAG-TDA, Hyper-CVAD, EURO, COG, T-Cell ALL protocol, and ALL protocol 9111).
 Results: Out of 84 patients, 55 (65.5%) patients were treated with Berlin-Frankfurt-Munster 76/79 protocol and the remaining 20 (23.81%) patients with other protocols. After the end of induction 64 (73.8%) patients achieved complete remission and 5 (5.95%) patients did not achieve Remission.
 Conclusion: Response rate of ALL (Acute Lymphoblastic Leukemia) patients treated with BFM 76/79 protocol was better than other protocols and possibly when risk adapted for male gender, WBC > 50 x 109/L and age> 30 years.
Highlights
Acute lymphoblastic leukemia (ALL) is a malignancy of the white blood cells and lymphoid lines of hematopoietic cells in the blood and bone marrow while lymphomas mostly involve the lymph nodes
Acute Lymphoblastic Leukemia is a cancerous disease of the bone marrow where immature leucocytes and lymphoid precursors proliferate and replace the normal hematopoietic cells and immune system B and T cells
Data of 129 patients aged from 2-54 years (83.0% patients between age 11 to 30 years) were assessed for eligibility on the basis ALL (n= 84), Acute Myeloid Leukemia (AML) (n=9) and NonHodgkin Lymphoma (NHL) (n=35) patients. 84 patients with ALL were selected for this study
Summary
Acute Lymphoblastic Leukemia is a cancerous disease of the bone marrow where immature leucocytes and lymphoid precursors proliferate and replace the normal hematopoietic cells and immune system B and T cells. Research has revealed that most of the deaths and poor outcomes of leukemia and lymphoma patients were due to many reasons i.e. lack of awareness about the disease, lack of early treatment of disease, the toxic effect of protocol or chemotherapy treatment, and poor socioeconomic condition of patients. Leukemia patients.[7] Toxicity is a major risk for long-term event-free-survival outcomes, so a balance in therapeutic treatment is required.[8] It is suggested that Risk adapted therapies are beneficial for good outcomes of patients in ALL.[5,9] Classification of Acute Leukemia according to FAB classification and World Health Organization was described so that the treatment should be given according to the diagnosis of a particular subtype.[10] Proper treatment should be given to ALL patients to attain improvement in survival rates and to decrease the rate of deaths due to infectious diseases.[11] High Relapse rate is a major problem in previous studies. The relapse rate was controlled by risk adapted therapy
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