Estudo epidemiológico dos casos de leucemia linfoide aguda nas crianças e adolescentes tratados no centro de tratamento onco-hematológico infantil - CETOHI , do hospital regional de Mato Grosso do Sul

Abstract

BACKGROUND: In a public institution children with de novo acute lymphoblastic leukemia were treated from January 2000 to December 2012, according to protocol GBTLI-LLA 99 and ALL-BFM-95/02.AIM: The aim of this study was to evaluate the experience with theses protocol, the treatment results according to the risk groups and to compare this experience data with the GBTLI-LLA 99 results. METHODS: Patients were stratified into 2 risk groups, based on initial white blood cell count, age, initial treatment response: low and high risk group. RESULTS: One hundred seventh nine children entered the study (male-female ratio was 1.48:1, the average age was 7 years and 7 months and the median age was 6 years and 4 months). 111 (62,92%) children were in the low risk, 68 (37,07%) in the high risk group. The overall complete remission rate was 88,26%. 21 (12,35%) children died in induction and 04 were non-responders. The 5-year overall survival for all patients was 61,5%, in the low risk group 70,10% and in the high risk group 52,7% the average age of follow was 6 years and 2 months and the median of follow up was 6 years and 5 months. Overall survival and event-free survival at 5 years follow-up of patients registered at the study GBTLI-99 group was superior to non-filed (SG - 69.7% / 57.3%; SLE - 67.1% / 52, 4%, respectively). From the 179 patients 110 (61,5%) are still in their first complete clinical remission and other 07 children are alive after relapse. In 22,3% of the patients relapse was diagnosed; the most common site was the bone marrow. The 5-year event free survival for all patients was 51,5%, in the low risk group 73,1% and in the high risk group 55,5%. CONCLUSION: The treatment outcome of children with acute lymphoblastic leukemia improved remarkably over the last decade. 61,5% of children suffering from acute lymphoblastic leukemia could be cured with the GBTLI-LLA 99 protocol. The results of the patients of this public institution were comparable with the results achieved by other services in Brazil and other countries.