The treatment of children with acute lymphoblastic leukemia in Thailand
การรักษาเด็กที่เป็นโรคมะเร็งเม็ดเลือดขาวชนิดเฉียบพลันแบบลิมโพบลาสต์ในประเทศไทย
Vichai Laosombat, Prof., D. of Pediatrics, F. of Medicine, PSU.
Malai Wongchanchailert, Asst. Prof., D. of Pediatrics, F. of Medicine, PSU.
Benjamas Sattayasevana, Medical Technologist, D. of Pediatrics, F. of Medicine, PSU.
Aranya Wiriyasateinkul, Nurse, D. of Pediatrics, F. of Medicine, PSU.
Somchai Watana-Arepornchai, D. of Radiology, F. of Medicine, PSU.
Corresponding e-mail : lvichai@ratree.psu.ac.th
Grant : Government Budget
Published : Medical and Pediatric Oncology 2000 (in press)
Key words : leukemia, lymphoblastic leukemia, modified CCSG-ALL protocols,
acute lymphoblastic leukemia (ALL)
Background : This study aimed to assess the outcome of children with acute lymphoblastic leukemia (ALL) using a modified ALL protocol of the Children's Cancer Study Group (CCSG) in a developing country.
Patients and Methods : The study was conducted at the Prince of Songkla University, Songkla, Thailand. From August 1986 through December 1998, 194 unselected children under the age of 15 years were diagnosed with ALL. Of them, 164 were evaluable. Therapy was stratified by prognostic criteria of the CCSG. Patients with good prognosis received MCCG-104, those with intermediate prognosis received MCCG-105 and those with poor and worse prognosis received MCCG-106. We deleted L-asparaginas from induction phase of the three protocols.
Results : The majority of patients (83%) had poor and worse prognosis. The 5-yr EFS for all
164 patients was 50% (95% CI 41-58) with a median follow-up duration of 56 months in patients
who had complete remission (ranged 9-157 months). The 5-yr EFS for patients with good, intermediate and poor and worse prognosis was 100%, 57% (95% CI 34-74) and 48% (95 CI 38-58) respectively.
Conclusions : The ALL protocols of the CCSG (CCG 104-106) can be modified to children
with ALL in developing country and were effective in improving the EFS.
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