Survival and prognostic factors of childhood acute lymphoblastic leukemia

Background The treatment protocols of childhood acute lymphoblastic leukemia (ALL) have been improved. Some factors such as age, sex, and nutritional status could influence therapy outcome. Objective To study the survival differences among age, sex, and nutritional status groups in childhood ALL. Methods A retrospective Kaplan-Meier survival analysis of childhood ALL was performed in Cipto Mangunkusumo Hospital since January 1st 1998 until December 31st 2003. We excluded patients aged < 1 years, those with L3 subtype, patients with modified chemotherapy protocol, or with incomplete data. Results A total of 252 patients were analyzed. Overall survival of 1-2 year old, > 2-< 10 year old, and 10-18 year old subjects were 57% (95% CI 38 to 76%), 47% (95% CI 40 to 54%), and 35% (95% CI 21 to 49%) respectively (P < 0.05). Five-year -event-free survival (EFS) of 1-2 year old, > 2-< 10 year old, and 10-18 year old subjects were 40%, 40%, and 16%, respectively (P <0.05). Overall survival of male and female subjects were 46% and 53% respectively (P >0.05). Five-year-EFS of male and female subjects were 29% and 45% (P >0.05). Overall survival of well-nourished, undernourished, and malnourished patients were 42%50% and 57% respectively (P >0.05). The five-year-EFS of wellnourished, undernourished, and malnourished subjects were 33%,38%, and 51%, respectively (P >0.05). Conclusion Childhood ALL aged 1-2 years had the highest survival rate while those of 10-18 year old had the lowest. There were no survival rate differences between sex and nutritional status groups