Cure rates of childhood acute lymphoblastic leukemia in Lithuania and the benefit of joining international treatment protocol

TY - JOUR

T1 - Cure rates of childhood acute lymphoblastic leukemia in Lithuania and the benefit of joining international treatment protocol

AU - Vaitkevičienė, Goda

AU - Matuzevičienė, Rėda

AU - Stoškus, Mindaugas

AU - Žvirblis, Tadas

AU - Ragelienė, Lina

AU - Schmiegelow, K.

N1 - Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

PY - 2014

Y1 - 2014

N2 - Background: Childhood acute lymphoblastic leukemia (ALL) represents the largest group of pediatric malignancies with long-term survival rates of more than 80% achieved in developed countries. Epidemiological data and survival rates of childhood ALL in Lithuania were lacking. Therefore, the aim of this study was to analyze the population-based long-term treatment results of childhood ALL in Lithuania during 1992-2012. Materials and methods: Data of all 459 children with T-lineage and B-cell precursor ALL treated in Lithuania from 1992 to 2012 were collected and analyzed. Results were compared among four time-periods: 1992-1996 (N = 132), 1997-2002 (N = 136), 2003-2008 (N = 109) and 2009-2012 (N = 82). Results: The incidence of childhood ALL in Lithuania was 3.2-3.6 cases per 100 000 children per year during the study period. Five-year probability of event-free survival increased from 50% ± 4% in 1992-1996 to 71% ± 4% in 2003-2008 (P < 0.001). Five-year cumulative incidence of relapses reduced from 27% ± 4.5% in 1992-1996 to 14% ± 3.6% in 2003-2008 (P = 0.042). After introduction of high-dose methotrexate of 5g/m2, cumulative incidence of CNSinvolving relapses reduced from 17% ± 3.9% in 1992-1996 to 1% ± 1.0% in 2003-2008 (P < 0.001). Trend for further improvement in survival was seen in 2009-2012 when Lithuania joined international the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL-2008 treatment protocol. Conclusions: Cure rates of childhood ALL in Lithuania are improving steadily and are now approaching those reported by the largest international study groups. The reasons for such a positive effect are both better financial support for treatment of children with cancer in Lithuania and international collaboration with joining international treatment protocol for childhood ALL.

AB - Background: Childhood acute lymphoblastic leukemia (ALL) represents the largest group of pediatric malignancies with long-term survival rates of more than 80% achieved in developed countries. Epidemiological data and survival rates of childhood ALL in Lithuania were lacking. Therefore, the aim of this study was to analyze the population-based long-term treatment results of childhood ALL in Lithuania during 1992-2012. Materials and methods: Data of all 459 children with T-lineage and B-cell precursor ALL treated in Lithuania from 1992 to 2012 were collected and analyzed. Results were compared among four time-periods: 1992-1996 (N = 132), 1997-2002 (N = 136), 2003-2008 (N = 109) and 2009-2012 (N = 82). Results: The incidence of childhood ALL in Lithuania was 3.2-3.6 cases per 100 000 children per year during the study period. Five-year probability of event-free survival increased from 50% ± 4% in 1992-1996 to 71% ± 4% in 2003-2008 (P < 0.001). Five-year cumulative incidence of relapses reduced from 27% ± 4.5% in 1992-1996 to 14% ± 3.6% in 2003-2008 (P = 0.042). After introduction of high-dose methotrexate of 5g/m2, cumulative incidence of CNSinvolving relapses reduced from 17% ± 3.9% in 1992-1996 to 1% ± 1.0% in 2003-2008 (P < 0.001). Trend for further improvement in survival was seen in 2009-2012 when Lithuania joined international the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL-2008 treatment protocol. Conclusions: Cure rates of childhood ALL in Lithuania are improving steadily and are now approaching those reported by the largest international study groups. The reasons for such a positive effect are both better financial support for treatment of children with cancer in Lithuania and international collaboration with joining international treatment protocol for childhood ALL.

U2 - 10.1016/j.medici.2014.05.005

DO - 10.1016/j.medici.2014.05.005

M3 - Journal article

C2 - 25060202

SN - 1010-660X

VL - 50

SP - 28

EP - 36

JO - Medicina (Lithuania)

JF - Medicina (Lithuania)

IS - 1

ER -