التفاصيل البيبلوغرافية
العنوان: |
The treatment of childhood acute lymphoblastic leukemia in Guatemala: Biologic features, treatment hurdles, and results |
المؤلفون: |
Federico Antillon, Emanuela Rossi, Dyna A. Borrayo, Rodolfo Lorenzana, Raul C. Ribeiro, Claudia Garrido, Mario Melgar, Emilia J. Osorio, Maria Grazia Valsecchi, Patricia D. Valverde, Verónica Girón, Valentino Conter, Monika L. Metzger, Mauricio Castellanos, Ricardo Mack, Jessica G. Blanco, Tomas R. Letona |
المصدر: |
Cancer. 123:436-448 |
بيانات النشر: |
Wiley, 2016. |
سنة النشر: |
2016 |
مصطلحات موضوعية: |
0301 basic medicine, Cancer Research, Pediatrics, medicine.medical_specialty, Chemotherapy, business.industry, medicine.medical_treatment, Cancer, medicine.disease, 03 medical and health sciences, Malnutrition, 030104 developmental biology, 0302 clinical medicine, medicine.anatomical_structure, Immunophenotyping, Oncology, Induction Death, 030220 oncology & carcinogenesis, White blood cell, medicine, Cumulative incidence, business, Childhood Acute Lymphoblastic Leukemia |
الوصف: |
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-Munster (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. |
تدمد: |
0008-543X |
URL الوصول: |
https://explore.openaire.eu/search/publication?articleId=doi_________::aaf01c1a296bb96ffba47a6b7773edac https://doi.org/10.1002/cncr.30257 |
حقوق: |
OPEN |
رقم الأكسشن: |
edsair.doi...........aaf01c1a296bb96ffba47a6b7773edac |
قاعدة البيانات: |
OpenAIRE |