BACKGROUND: The National Pediatric Oncology Unit (UNOP) is the only pediatric hemato-oncology center in Guatemala. METHODS: Patients ages 1 to 17 years with acute lymphoblastic leukemia (ALL) were treated according to modified ALL Intercontinental Berlin-Frankfurt-Münster (IC-BFM) 2002 protocol. Risk classification was based on age, white blood cell count, immunophenotype, genetics (when available), and early response to therapy. RESULTS: From July 2007 to June 2014, 787 patients were treated, including 160 who had standard-risk ALL, 450 who had intermediate-risk ALL, and 177 who had high-risk ALL. The induction death rate was 6.6%, and the remission rate was 92.9%. The rates of death and treatment abandonment during first complete remission were 4.8% and 2.5%, respectively. At a median observation time of 3.6 years, and with abandonment considered an event, the 5-year event-free survival and overall survival estimates (± standard error) were 56.2% ± 2.1% and 64.1% ± 2.1%, respectively, with a 5-year cumulative incidence of relapse of 28.9% ± 2.0%. Twenty-one of 281 patients (7.5%) investigated were positive for the ets variant 6/runt-related transcription factor 1 (ETV6/RUNX1) fusion. CONCLUSIONS: A well organized center in a low-middle-income country can overcome the disadvantages of malnutrition and reduce abandonment. Outcomes remain suboptimal because of late diagnosis, early death, and a high relapse rate, which may have a partly genetic basis. Earlier diagnosis, better management of complications, and better knowledge of ALL will improve outcomes. Cancer 2017;123:436–448. © 2016 American Cancer Society.
Antillón, F., Blanco Lopez, J., Valverde, P., Castellanos, M., Garrido, C., Girón, V., et al. (2017). The treatment of childhood acute lymphoblastic leukemia in Guatemala: Biologic features, treatment hurdles, and results. CANCER, 123(3), 436-448 [10.1002/cncr.30257].
|Citazione:||Antillón, F., Blanco Lopez, J., Valverde, P., Castellanos, M., Garrido, C., Girón, V., et al. (2017). The treatment of childhood acute lymphoblastic leukemia in Guatemala: Biologic features, treatment hurdles, and results. CANCER, 123(3), 436-448 [10.1002/cncr.30257].|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||Si|
|Titolo:||The treatment of childhood acute lymphoblastic leukemia in Guatemala: Biologic features, treatment hurdles, and results|
|Autori:||Antillón, F; Blanco Lopez, J; Valverde, P; Castellanos, M; Garrido, C; Girón, V; Letona, T; Osorio, E; Borrayo, D; Mack, R; Melgar, M; Lorenzana, R; Ribeiro, R; Metzger, M; Conter, V; Rossi, E; Valsecchi, M|
|Data di pubblicazione:||2017|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1002/cncr.30257|
|Appare nelle tipologie:||01 - Articolo su rivista|