Childhood T-lineage acute lymphoblastic leukemia: Management and outcome at a tertiary care center in North India

• Published in: Indian pediatrics Vol. 48; no. 10; pp. 785 - 790
• Main Authors: Arya, L. S., Padmanjali, K. S., Sazawal, S., Saxena, R., Bhargava, M., Kulkarni, K. P., Adde, M., Magrath, I.
• Format: Journal Article
• Language: English
• Published: India Springer-Verlag 01.10.2011
• Subjects: Adolescent; Child; Child, Preschool; Combined Modality Therapy; Disease-Free Survival; Female; Humans; India; Infant; Male; Maternal and Child Health; Medicine; Medicine & Public Health; Pediatric Surgery; Pediatrics; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - therapy; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - therapy; Remission Induction; Research Paper; Retrospective Studies; Treatment Outcome; India; Relapse; Prognosis; Acute lymphoblastic leukemia; B-lineage; Outcome; T-lineage; Child; Survival
• ISSN: 0019-6061; 0974-7559
• DOI: 10.1007/s13312-011-0129-3

Objective To assess the clinical features, prognostic factors and outcome of childhood T-ALL in comparison with B-lineage ALL, treated with a uniform treatment regimen (MCP 841). Setting Pediatric oncology division of a tertiary care institution in Northern India. Design Retrospective analysis of clinical data and survival outcome. Participants 60 children with T-ALL and 139 with Blineage ALL, and less than 15 years of age treated over 15 years. Results T-ALL was observed in 30%. High risk features at presentation (age ≥10 years, WBC >50,000/mm 3 , mediastinal mass, and CNS leukemia) were significantly more frequent in T-ALL as compared to B-lineage ALL ( P =0.049, P <0.001, P <0.001 and P =0.02, respectively). Fifty five of 60 T-ALL patients (91.7%) achieved complete remission after induction therapy. There were 3 induction and 10 remission deaths while 11 (18.3%) relapsed. The overall survival and event-free survival of T-lineage ALL (61.5±7.6 and 49.9±7.4, respectively) were similar to that of B-lineage patients (68.7±4.7 and 47.1±5.1, respectively). National Cancer Institute risk groups emerged as significant prognostic factor for event free survival only in B-lineage patients. Conclusions Even though high risk features were significantly more frequent in T-ALL, survival outcome was similar to that of B-lineage patients. None of the routinely described prognostic parameters significantly impacted survival.