Survival rate of children acute lymphoblastic leukemia at the end of therapy protocol with minimal residual disease (MRD) in Prof I G.N.G. Ngoerah General Hospital Denpasar

Abstract

Link of Video Abstract: https://youtu.be/5DFCQHg86rU Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Although the survival rate of pediatric patients with ALL is currently improving, cases of relapse still occur. Minimal residual disease (MRD) status is a prognostic factor that plays an important role in recurrence of ALL patients who have been through induction therapy. Aim: To determine the survival rate in pediatric patients with ALL based on negative MRD examination is better than positive MRD at the end of therapy. Method: A retrospective cohort study with inclusion criteria including pediatric patients aged 1 to 18 years who were diagnosed with ALL in the period of 2017-2019 at Sanglah General Hospital, Denpasar. Subject’s recruitment was initiated when the minimum number of subjects was fulfilled. Result: From 32 research subjects, the mean age was 5.1 years, the majority obtained MRD+ results, the dominant sex was male, the average leukocyte was 28.33 thousand, most of the subjects had no mediastinal masses, and generally experienced remissions. MRD levels were found to be significantly lower in remitting patients than patients who did not achieve remission (p value <0.05). The Kaplan-Meier estimates for event-free survival on MRD status (negative versus positive) were 84.6% and 42.1% (P = 0.030). Conclusion: There was a significant relation between MRD levels and the survival rate to achieve remission and MRD levels are significantly lower in remitting patients than patients who do not achieve remission.