Effectiveness of Indonesian Acute Lymphoblastic Leukemia 2006 Protocol in Semarang
yetty movieta,Bambang Sudarmanto,Moedrik Tamam,AG Soemantri
FK UNDIP FK Undip RSUP DR KARIADI
Background : The incidence of leukemia disease increased rapidly from year to year in almost all cities in Indonesia and around the world. In 2006 The Indonesian Hematology Oncology Pediatric Working Group made a more intensive protocol named Indonesia 2006 protocol for ALL. This protocol consists of cytostatic combination for 2 years and divided into 4 phases without re-induction for standard risk group and 4 phases for High risk group. The objective of this study was to report the effectiveness of Indonesia 2006 protocol for Childhood Acute Lymphoblastic Leukemia in Semarang.
Material : This is a single center study at Kariadi Hospital Semarang . All patients aged 1-18 years with diagnosed ALL from 2012 until 2017 treated with Indonesia 2006 Protocol for ALL were evaluated.
Results : There were 324 patients with newly diagnosed ALL entered this study. Based on NCI criteria standard risk group was higher ( SR: HR = 69,8%: 30,2%). From all subject who involved, we found induction remission achievement was 68,51% . In total 58,6 % patients completed the treatment but only 68 (20,9%) patients still remission after the end of maintenance phase. There were 48 (14,8%) patients relapsed and most of them who were in high risk grup (30 patients). Early relapse was predominant compare with late relapse ( 56,25% Vs 43,74%). Bone marrow was the most common relapse (72,9%). Drop out cases were still high (30%). There were 108 death cases were found during treatment. Bleeding is the most common cause (65%) followed by sepsis (35%).
Conclusions : The high rate of relapse need a new strategy especially in limited resources area. The future protocol should be developed based on the recent problem.
Keywords: Indonesia 2006 ALL protocol
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