Prognostic factors analysis in a therapeutic trail of acute lymphoblastic leukaemia (ALL).

ABSTRACT

It is common practice in therapeutic trials in Acute Lymphoblastic Leukaemia (ALL) to analyse the impact of prognostic factors on clinical outcome. In this study, 30 newly diagnosed ALL patients were enrolled and the median age was 14.5 years. 22 patients were male and 8 patients were female. Prognostic factors analysed include age, sex, lymphomatous presentations (bulky peripheral lymphadenopathy, mediastinal mass and enlargement of spleen and liver), initial leucocyte count, blast cell morphology and bone marrow response to chemotherapy. Remission induction and maintenance therapy with conventional combination chemotherapy and CNS prophylaxis with intra thecal methotrexate and radiotherapy were instituted to all patients for long term event free survival. Results of induction therapy and overall outcomes of treatment were observed. The impacts of analyzed prognostic factors on clinical outcomes were assessed. 3 patients (10%) failed to go into remission after 12 weeks of therapy. 27 patients (90%) obtained remission. Among 27 patients those obtained remission, 17 patients continued event (failure to remit, relapse and death) free survival, 7 patients suffered relapse of their leukaemia and 3 patients died during maintenance therapy. Events were observed more among patients age group > or = 20 yrs (84%), initial WBC count > or = 50 x 10(9)/L (58%) and FABL2 morphology (80%).