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Analysis of outcomes and prognostic factors of acute lymphoblastic leukemia patients treated by MCP841 protocol: A regional cancer center experience

View Article: PubMed Central - PubMed

ABSTRACT

Background:: A dramatic improvement in the survival of acute lymphoblastic leukemia (ALL) patients in the last three decades has been observed. MCP 841 protocol is an old but effective tool with tolerable toxicities. The objective of this study was to estimate the relapse-free survival of ALL patients treated uniformly with MCP 841 protocol on the basis of various prognostic factors.

Materials and methods:: The study design was retrospective and it was conducted in a regional cancer center of Northwest India. Three hundred and ten ALL patients who underwent treatment with MCP 841 protocol and regular follow-up for up to 5 years were selected for this study. Relapse-free survival was calculated by Kaplan–Meier analysis and Cox regression analysis was used to calculate the hazards ratio (HR) using Statistical Package for the Social Sciences (SPSS) software for windows version 20.0.

Results:: Fifty-four percent patients were <15 years of age and 69% were males. 53.2% patients were in remission at the end of 5 years of starting the treatment. Relapse-free survival at 5 years by Kaplan–Meir analysis for B-cell ALL was 62% [HR 0.67 {95% confidence interval (CI) 0.47-0.95}] with patients with unknown lineage taken as reference] while for T cell it was 28% [HR 1.41 (95% CI 1.19-1.63), P 0.001]. Patients with total leukocyte count (TLC) <1 lakh/cmm at presentation, relapse-free survival was 68% and those with TLC >1 lakh/cmm had 41% survival [HR 2.14 (1.76-2.48) with, P < 0.001].

Conclusion:: MCP 841 protocol is a useful tool for the treatment of ALL in children when more aggressive protocols can not be used.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier survival plot showing 5-year relapse-free survival probability for T-cell ALL and B-cell ALL
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Figure 1: Kaplan–Meier survival plot showing 5-year relapse-free survival probability for T-cell ALL and B-cell ALL

Mentions: Overall, the 5-year survival was 53.2%. Relapse-free survival at 5 years by Kaplan–Meir analysis for B-cell ALL was 62% while for T cell it was 28% (P < 0.001) [Figure 1]. The mean survival for B and T lineages was 39.35 months and 26.38 months, respectively [hazards ratio (HR) 1.41, 95% CI 1.19-1.63, P 0.002]. Table 4 summarizes the results of statistical tests for survival analysis for various subgroups. In patients with day 15 PBF without blast, relapse-free survival was 65% while in those with persistent blast, it was 45% (P < 0.001). In patients with TLC <1 lakh at presentation, relapse-free survival was 68% and in those with TLC >1 lakh had 41% survival with a mean survival of 42.51 months and 30.99 months, respectively (HR 2.14, 95% CI 1.76-2.48, P < 0.001) [Figure 2]. CALLA-positive patients had 95% survival while CALLA-negative patients had only 20% survival (HR 2.46, 95% CI 1.48-4.09, P < 0.001). For the <3 years age group, survival was 30% (HR 2.90 with reference to 3-10 years age group, 95% CI 1.55-5.44, P < 0.001), for the >20 years age group it was 15%, for the 3-10 years age group and 11–15 years age group it was 65% and 64%, respectively, while for the 16-20 years age group, it was 59% (P < 0.001,) [Figure 3]. The mean survival time for <3 years age group was 21.34 months, for 3-10 years, 11-15 years, and 16-20 years, it was 41.59 months, 40.82 months, and 40.20 months, respectively, while for >20 years, it was 18.34 months (HR 3.39, 95% CI 2.09-5.51, P < 0.001). However, the data were not statistically significant for males (50%) versus females (60%) (P 0.24).


Analysis of outcomes and prognostic factors of acute lymphoblastic leukemia patients treated by MCP841 protocol: A regional cancer center experience
Kaplan–Meier survival plot showing 5-year relapse-free survival probability for T-cell ALL and B-cell ALL
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121999&req=5

Figure 1: Kaplan–Meier survival plot showing 5-year relapse-free survival probability for T-cell ALL and B-cell ALL
Mentions: Overall, the 5-year survival was 53.2%. Relapse-free survival at 5 years by Kaplan–Meir analysis for B-cell ALL was 62% while for T cell it was 28% (P < 0.001) [Figure 1]. The mean survival for B and T lineages was 39.35 months and 26.38 months, respectively [hazards ratio (HR) 1.41, 95% CI 1.19-1.63, P 0.002]. Table 4 summarizes the results of statistical tests for survival analysis for various subgroups. In patients with day 15 PBF without blast, relapse-free survival was 65% while in those with persistent blast, it was 45% (P < 0.001). In patients with TLC <1 lakh at presentation, relapse-free survival was 68% and in those with TLC >1 lakh had 41% survival with a mean survival of 42.51 months and 30.99 months, respectively (HR 2.14, 95% CI 1.76-2.48, P < 0.001) [Figure 2]. CALLA-positive patients had 95% survival while CALLA-negative patients had only 20% survival (HR 2.46, 95% CI 1.48-4.09, P < 0.001). For the <3 years age group, survival was 30% (HR 2.90 with reference to 3-10 years age group, 95% CI 1.55-5.44, P < 0.001), for the >20 years age group it was 15%, for the 3-10 years age group and 11–15 years age group it was 65% and 64%, respectively, while for the 16-20 years age group, it was 59% (P < 0.001,) [Figure 3]. The mean survival time for <3 years age group was 21.34 months, for 3-10 years, 11-15 years, and 16-20 years, it was 41.59 months, 40.82 months, and 40.20 months, respectively, while for >20 years, it was 18.34 months (HR 3.39, 95% CI 2.09-5.51, P < 0.001). However, the data were not statistically significant for males (50%) versus females (60%) (P 0.24).

View Article: PubMed Central - PubMed

ABSTRACT

Background:: A dramatic improvement in the survival of acute lymphoblastic leukemia (ALL) patients in the last three decades has been observed. MCP 841 protocol is an old but effective tool with tolerable toxicities. The objective of this study was to estimate the relapse-free survival of ALL patients treated uniformly with MCP 841 protocol on the basis of various prognostic factors.

Materials and methods:: The study design was retrospective and it was conducted in a regional cancer center of Northwest India. Three hundred and ten ALL patients who underwent treatment with MCP 841 protocol and regular follow-up for up to 5 years were selected for this study. Relapse-free survival was calculated by Kaplan&ndash;Meier analysis and Cox regression analysis was used to calculate the hazards ratio (HR) using Statistical Package for the Social Sciences (SPSS) software for windows version 20.0.

Results:: Fifty-four percent patients were &lt;15 years of age and 69% were males. 53.2% patients were in remission at the end of 5 years of starting the treatment. Relapse-free survival at 5 years by Kaplan&ndash;Meir analysis for B-cell ALL was 62% [HR 0.67 {95% confidence interval (CI) 0.47-0.95}] with patients with unknown lineage taken as reference] while for T cell it was 28% [HR 1.41 (95% CI 1.19-1.63), P 0.001]. Patients with total leukocyte count (TLC) &lt;1 lakh/cmm at presentation, relapse-free survival was 68% and those with TLC &gt;1 lakh/cmm had 41% survival [HR 2.14 (1.76-2.48) with, P &lt; 0.001].

Conclusion:: MCP 841 protocol is a useful tool for the treatment of ALL in children when more aggressive protocols can not be used.

No MeSH data available.


Related in: MedlinePlus