loading page

Relapsed childhood acute lymphoblastic leukemia: Experience from a single tertiary center in Thailand
  • +2
  • Thirachit Chotsampancharoen,
  • Natsaruth Songthawee,
  • Shevachut Chavananon,
  • Pornpun Sripornsawan,
  • Edward McNeil
Thirachit Chotsampancharoen
Prince of Songkla University Faculty of Medicine

Corresponding Author:[email protected]

Author Profile
Natsaruth Songthawee
Prince of Songkla University Faculty of Medicine
Author Profile
Shevachut Chavananon
Prince of Songkla University Faculty of Medicine
Author Profile
Pornpun Sripornsawan
Prince of Songkla University Faculty of Medicine
Author Profile
Edward McNeil
Prince of Songkla University
Author Profile

Abstract

BACKGROUND: Few studies have examined survival in relapsed childhood acute lymphoblastic leukemia (ALL) in resource-limited countries. The aims of this study were to evaluate the incidence, prognostic factors, and survival of relapsed childhood ALL in Thailand. METHODS: The medical records of patients with ALL aged <15 years in the major tertiary care institution in Southern Thailand between January 2000 and December 2019 were retrospectively reviewed. The Kaplan-Meier method was used to depict the overall survival (OS). RESULTS: A total of 472 patients with ALL were enrolled. The incidence of relapsed ALL was 32.8%. Of the 155 relapsed patients, 131 (84.5%) and 24 (15.5%) had B-cell and T-cell phenotypes, respectively. One hundred thirteen (72.9%) and 42 (27.1%) patients had early and late relapses, respectively. The most common site of relapse was bone marrow in 102 patients (65.8%). One hundred twenty-eight (82.6%) and 27 (17.4%) patients received or refused the relapse chemotherapy, respectively. The 5-year OS of all relapsed patients was 11.9%. The 5-year OS among the patients with early relapse was significantly lower than in the patients with late relapse (5.3% vs. 29.1%, respectively, p <0.0001). Site and immunophenotype were not associated with survival of relapsed ALL. The patients who refused chemotherapy had a median survival time of 3.1 months. CONCLUSION: The relapse rate was one third of patients with ALL. The 5-year OS was 12% and patients who refused chemotherapy had a median survival time of 3 months.