Abstract Ref Number = APCP933
OUTCOMES AFTER INDUCTION FAILURE IN CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA
Eva Luchinta,Fhisherra Kusuma,Christiana Dita,Bambang Ardianto,Eddy Supriyadi,Pudjo Hagung Widjajanto,Sutaryo
DR Sardjito General Hospital
Background : Since 2013, acute lymphoblastic leukemia (ALL) patients in Dr. Sardjito General Hospital, had been treated with the Indonesian ALL-2013 protocol and ALL-2016 protocol. The failure rate after induction phase therapy is still high and related to poor prognosis. This study was conducted to determine the outcome after induction failure in children with ALL.
Material : This was a retrospective study. Data were taken from medical record of ALL patients at Dr. Sardjito General Hospital from 2013 to 2017. The subjects were less than 18 years old, newly diagnosed as ALL, and had completed the induction phase. The outcomes were measured as event-free survival (EFS).
Results : There were 248 patients, 57 (23%) failed to achieve complete remission. Of the 57 patients with induction failure, 47 patients treated with ALL protocol 2013 and 10 patients treated with ALL protocol 2016. From 47 patients treated with ALL protocol 2013, 25 were in high risk (HR) group and 22 were in standard risk (SR) group. In HR group, 9 patients relapsed, 6 patients died, 3 patients were dropped out and 7 patients were alive. In SR group, 4 patients relapsed, 6 patients died, 5 patients were dropped out and 7 patients were alive. From 10 patients treated with ALL protocol 2016, 6 were in HR group and 4 were in SR group. In HR group, 1 patient relapsed, 2 patients died and 3 patients were alive. In SR group, 2 patients relapsed and 2 patients were alive. The EFS rate for HR and SR group were 28% and 23,9% for 2013 protocol (p=0,657) and 33,3% and 37,5% for 2016 protocol (p=0,479).
Conclusions : Patients who failed to reach complete remission increase the occurrence of relapse and death in children with ALL. The EFS rate was low. Therefore, new protocol for patients with induction failure is needed.
Keywords: acute lymphoblastic leukemia induction failure remission