ABSTRACT
OBJECTIVE: To compare the outcome of induction-remission in acute lymphoblastic leukaemia patients treated according to two different guidelines. METHODS: The descriptive retrospective cohort study was conducted at The Children's Hospital Lahore, Pakistan, and comprised clinical information sheets of acute lymphoblastic leukaemia patients from September 2014 to August 2015. Data regarding demographics, risk categorisation, rapid early response and induction-remission assessment was collected separately for Group 1 patients treated with Lahore protocol and Group 2 patients using United Kingdom acute lymphoblastic leukaemia-2011 interim guidelines. Data was analysed using SPSS version 20.0. RESULTS: Of the 98 patients who had a median age of 6.4 years (interquartile range: 1.5-16 years), 48(49%) were in Group 1 and 50(51%) in Group 2. There were 14(29%) patients with standard risk in Group 1 while 34(71%) were high-risk. The corresponding numbers in Group 2 were 30(60%) and 20(40%) in Group 2. Rapid early response was noted in 18(37.5%) patients in Group 1 and 11(28%) in Group 2. Remission was achieved in 38(79%) patients in Group 1 and 36(72%) in Group 2. There was significant association of rapid early response with induction-remission in Group 2 (p<0.05) but not in Group 1 (p>0.05). CONCLUSIONS: Induction-remission rate was comparable in the two treatment groups, but significant association of rapid early response with induction-remission was observed only in patients treated using United Kingdom acute lymphoblastic leukaemia-2011 interim guidelines.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Remission Induction/methods , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/standards , Asparaginase/administration & dosage , Asparaginase/adverse effects , Bone Marrow Examination/methods , Child , Daunorubicin/administration & dosage , Daunorubicin/adverse effects , Female , Glucocorticoids/administration & dosage , Glucocorticoids/adverse effects , Humans , Leukocyte Count/methods , Male , Pakistan , Practice Guidelines as Topic , Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Retrospective Studies , Risk Adjustment/methods , Risk Factors , Treatment Outcome , Vincristine/administration & dosage , Vincristine/adverse effectsABSTRACT
With cancer being the third leading cause of mortality in the United Arab Emirates (UAE), there has been significant investment from the government and private health care providers to enhance the quality of cancer care in the UAE. The UAE is a developing country with solid economic resources that can be utilized to improve cancer care across the country. There is limited data regarding the incidence, survival, and potential risk factors for cancer in the UAE. The UAE Oncology Task Force was established in 2019 by cancer care providers from across the UAE under the auspices of Emirates Oncology Society. In this paper we summarize the history of cancer care in the UAE, report the national cancer incidence, and outline current challenges and opportunities to enhance and standardize cancer care. We provide recommendations for policymakers and the UAE Oncology community for the delivery of high-quality cancer care. These recommendations are aligned with the UAE government's vision to reduce cancer mortality and provide high quality healthcare for its citizens.
Subject(s)
Neoplasms/epidemiology , History, 21st Century , Humans , United Arab EmiratesABSTRACT
Medical literature does not have clear consensus on inter-rater reliability of PS assessment by different oncology health care professionals (HCPs) although it plays an important role in treatment decision and prognosis for oncology patients. Eastern Cooperative Oncology Group (ECOG) and Karnofsky performance status (KPS) scores are commonly used for this purpose by oncology HCPs around the world. This study was conducted to find variability or similarities in assessment of PS among the different oncology HCPs. A survey based on four hypothetical clinical scenarios was devised and sent to 50 oncology HCPs to assess the PS using ECOG PS tool. No significant variations in PS assessment by oncology HCPs was noted in our study sample.
