Global and disease-free survival in a peruvian cohort of patients with acute lymphoblastic leukemia

Abstract

Objective. To know the five-year survival and its associated factors in patients with Acute Lymphoblastic Leukemia (ALL) in Peru. Materials and Methods. A retrospective cohort of patients with ALL treated with chemotherapy in a Peruvian hospital for 13 years was studied. The dependent variables were overall survival (OS) and disease-free survival (DFS). Possible factors that might be associated with diagnosis and response to treatment were evaluated using the Cox proportional risk method. Results. The mortality rate was 32.5% and the relapse rate was 66.1%. The factors associated with lower overall survival were leukocyte count at diagnosis (HR: 1.01; 95% CI: 1.01-1.03), lineage other than B (HR: 2.15; 95% CI: 1,06-4,41), age at diagnosis (HR: 1,09; 95% CI: 1,03-1,16), bone marrow relapse (HR: 6,81; 95% CI: 4,14- 11,21) and induction failure (HR: 3,04; 95% CI: 1,47-6,32). Factors associated with lower disease-free survival: male gender (HR: 1.43; 95% CI: 1.10-1.86), age at diagnosis (HR: 1.06; 95% CI: 1.02-1.10) and leukocytes at diagnosis (HR: 1.01; 95% CI: 1.002-1.011). Conclusions. The five-year OS and DFS figures for our population are lower than those for the world. More studies are needed to know the factors involved in this reality and thus generate interventions aimed at improving the survival and quality of life of our patients. The variables associated with the decrease in both survival indicators were age and leukocyte count at the time of diagnosis, so the process of disease diagnosis must be improved.