Zahari, Nor Fadhilah
(2013)
Survival of children with acute leukaemia in paediatric oncology HUSM from 1990 to 2010.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction
It is well known that there is difference in survival of children with acute leukaemia
between developed and developing countries. However, there are lack of reports in the
treatment outcome and the survival of children with acute leukaemia in developing
countries including Malaysia. To date, there is no published study predicting the
treatment outcome in Hospital USM.
Objectives
The objectives of this study were to evaluate the overall survival (OS) and event free
survival (EFS) rate and to identify factors that determine the EFS of childhood Acute
Lymphoblastic Leukaemia (ALL) and Acute Myeloid Leukaemia (AML) in Hospital
USM.
Methodology
This study was a retrospective record review of children from newborn to 12 years old
who were diagnosed with ALL and AML and received chemotherapy in Paediatric
Oncology Unit Hospital USM from year 1990 to 2010. Children who were recruited
were identified from registry in paediatric oncology unit and medical records in
Hospital USM. Multiple Cox Regression model was used to predict the poor prognostic
factors for increased risk of death or relapsed for ALL and AML separately.Results
There were 334 acute leukaemia children (257 ALL and 77 AML) in the registry. Out
of these, 224 ALL and 59 AML were enrolled, giving a response rate of 87% for ALL
and 77% for AML. The mean duration of follow up was 73 months. The OS rate for
ALL at 1, 3 and 5 years were 77.7%, 66.9% and 63.5% respectively and for AML were
59.3%, 41.4% and 39.1% respectively. The EFS rate for ALL at 1, 3 and 5 years were
69.6%, 54.1% and 47.8%, for AML were 52.0%, 40.6% and 38.1% respectively.
Multivariate analysis showed that the independent poor prognostic factor for ALL are
presenting age at diagnosis; age above 10 years old (HR 3.6; 95% CI: 1.9-6.7), and aged
between 5 to 9.9 years old (HR 1.6; 95% CI: 1.1-2.4).
Similar analysis showed that spleen size > Scm (HR 4.1; 95% CI: 1.4-11.1 ), and
treatment protocol with AML BFM-87 (HR 2.9; 95% CI: 1.3-6.3) were independent
poor prognostic factors for AML compared to spleen size~ Scm and AML 12 UK
protocol.
Conclusion
Survival rate in this study was comparable to developing countries but remained low
compared to developed countries. The study had also identified a few prognostic factors
for increased risk of death and relapsed in ALL and AML for the local set up.
Actions (login required)
 |
View Item |
