Abstract
Introduction: Acute leukaemia in children accounts for 25-30% of malignant diagnosis. Survival from acute leukaemia continue to improve. Treatment outcome depends on factors like gender, age at diagnosis, parental education, the initial total white cell count (TWC), cerebrospinal fluids (CSF) infiltration, immunophenotype and treatment response. Objectives: The objectives were to evaluate the survival of children with acute leukaemia who received chemotherapy and identify relevant factors. Methodology: The study was a retrospective record review at the Paediatric Oncology Unit, Hospital Universiti Sains Malaysia (Hospital USM). The data collected depending on pre-set research proforma from the year 1990 to 2010. Survival analysis of each type of leukaemia was completed using multiple Cox regression model. Results: A total of 334 cases were identified, only 283 patients received treatment at Hospital USM. There were 224 patients with acute lymphoblastic leukaemia (ALL) and 59 with acute myeloid leukaemia (AML). Overall survival (OS) rate at 3 months for ALL and AML were 89.3% and 72.9% respectively. The event-free survival (EFS) rate for ALL at 1, 3, and 5 years were 69.6%, 54.1% and 47.8% respectively. For AML, the EFS rate at 1, 3, and 5 years were 52.0%, 42.4% and 38.1% respectively. Multiple Cox regression model showed children’s age at diagnosis and early response to steroid therapy were the most significant prognostic factors for ALL survival, whereas the spleen size and treatment protocol were the most significant prognostic factors for AML. Conclusion: Survival rate in this study was comparable to developing countries. ALL had better outcome compared to AML.
Highlights
Acute leukaemia in children accounts for 25-30% of malignant diagnosis
The survival rate of children with acute lymphoblastic leukaemia (ALL) is better than acute myeloid leukaemia (AML) with overall survival (OS) at 83% for ALL, and 54% for AML in Northern Europe (3)
The objective of the study is to determine the survival of children with acute leukaemia (ALL and AML) who received chemotherapy in Paediatric Oncology Unit at Hospital USM from the 1st January 1990 - 31st December 2010
Summary
Acute leukaemia in children accounts for 25-30% of malignant diagnosis. Survival from acute leukaemia continue to improve. Objectives: The objectives were to evaluate the survival of children with acute leukaemia who received chemotherapy and identify relevant factors. Overall survival (OS) rate at 3 months for ALL and AML were 89.3% and 72.9% respectively. For AML, the EFS rate at 1, 3, and 5 years were 52.0%, 42.4% and 38.1% respectively. Multiple Cox regression model showed children’s age at diagnosis and early response to steroid therapy were the most significant prognostic factors for ALL survival, whereas the spleen size and treatment protocol were the most significant prognostic factors for AML. The survival rate of children with acute lymphoblastic leukaemia (ALL) is better than acute myeloid leukaemia (AML) with overall survival (OS) at 83% (95% CI: 80-85) for ALL, and 54% (95% CI: 46-62) for AML in Northern Europe (3). In Malaysia, the 2-yearsurvival rate for ALL from 1980-1995 was 67% [5]
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