Infant Leukemia, Single-Center Eight Years' Experience

Abstract

Objectives: The aim of this study is to evaluate the clinical course, laboratory findings and treatment outcomes of the infant patients diagnosed with leukemia treated in our center. Design: This is a retrospective study of all the patients below one year old who diagnosed with leukemia and treated in King Fahd specialist hospital in Dammam, pediatric hematology/ oncology department between 1st January 2011 and 1st December 2018, our study included 14 cases. Setting: It is a single center study at King Fahad Specialist Hospital in Dammam which is 400 beds tertiary referral hospital with 27 beds pediatric oncology Ward, 2 beds bone marrow transplant and 18 bed pediatric oncology day care services. Methods and Results: All data and information of patients including laboratory results were retrieved from patients’ files and electronic medical records. Data analysis was done by using Statistical Package for the Social Sciences (SPSS) program version. Results: Within our study period we diagnosed 13 cases with infantile leukemia out of 202 cases of childhood leukemia in 8 years period (incidence of 6.4%) with overall survival of 61.5%. Conclusion: The incidence of ALL in infants is significantly lower than in other groups of children it tends to be presented with aggressive clinical features at diagnosis, including hyper leukocytosis, massive organomegaly, and central nervous system (CNS) involvement. The management particularly challenging, the outcome is inferior with tendency towards refractory course and increased relapse rates. In our study the survival rate was 61.5% which is minor better than what was reported in some centers for theses group of patients probably masked by the small number of patients in our study. More studies with larger patient numbers are needed to reevaluate HSCT's eligibility criteria in this group of patients, in addition to studying some new strategies such as CAR-T cell, targeted therapies, improving conditioning regimens, and maximize the supportive care should all be considered to improve the prognosis.