Asia Pacific Journal of Pediatric and Child Health

Abstract Ref Number = APCP937

Poster Presentation

OUTCOMES OF RELAPSED CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA TREATED WITH THE INDONESIAN ALL-2013 PROTOCOL AT DR SARDJITO GENERAL HOSPITAL

Hario Widhi Nugroho,Indri Ariesta,Cresti Chandra,Eddy Supriyadi,Pudjo Hagung Widjajanto,Sri Mulatsih,Sutaryo Faculty of Medicine Public Health and Nursing Universitas Gadjah Mada Yogyakarta Indonesia Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia Department of Child Health, Dr Sardjito General Hospital, Yogyakarta, Indonesia

Background : Since 2013, patients with acute lymphoblastic leukemia (ALL) in Dr. Sardjito General Hospital, Yogyakarta, had been treated with the Indonesian ALL-2013 protocol and some of them relapsed. Relapse remains the most common cause of treatment failure and has been correlated with poor prognosis. This study was conducted to find out the outcomes of relapsed childhood ALL patients treated with the Indonesian ALL-2013 protocol at Dr. Sardjito General Hospital. Material : Patients with first event of relapse were included in this retrospective study. Data were collected from medical records in Dr. Sardjito General Hospital between January 1st, 2013 and April 30th, 2018. The characteristics of patients, including sex, age group, time of relapse, risk stratification, and outcomes of relapse, were analyzed. Overall survival rate was also analyzed with Kaplan-Meier analysis. Results : From 175 patients treated with the Indonesian ALL-2013 protocol, 42 relapsed, which consist of 25 males and 17 females. There were 29 patients who were diagnosed at 1-10 years old and 13 patients at 10-18 years old. Only 1 patient relapsed during consolidation phase, 28 patients relapsed during maintenance phase, and 13 patients relapsed after finishing the treatment protocol. There were 22 high risk patients and 20 standard risk patients. In high risk patients, 1 patient relapsed, 11 patients died, 8 patients were dropped out, and 2 patients are still continuing therapy, while in standard risk patients, 10 patients died, 4 patients were dropped out, and 6 patients are still continuing therapy. Overall survival rate for the relapsed patients in high risk patients was 18.5%, while in standard risk patients was 35.7% (p=0.665). Conclusions : The outcomes of relapsed patients were poor, especially in high risk patients. The overall survival rate was low. Further evaluations in relapse causes and treatment protocol review are needed.

Keywords: Acute Lymphoblastic Leukemia Relapse Outcomes Childhood