Outcome of children treated for relapsed acute lymphoblastic leukemia in central America

  • Marjerrison S
  • Antillion F
  • Fu L
 et al. 
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Purpose: Outcomes for relapsed childhood acute lymphoblastic leukemia (ALL) are uncertain in resource-limited settings. We examined survival for relapsed ALL in Central America. Methods: We performed a retrospective cohort study and included children with ALL diagnosed with relapsed ALL in Guatemala, Honduras and El Salvador between 1990 and 2011, generally treated according to common protocols. Event-free survival (EFS) and overall survival (OS) were described using the Kaplan-Meier method. Predictors of EFS and OS were analyzed with the Cox proportional hazard model. Events censored for EFS included death, relapse, refractory disease, and abandonment. Data were collected from the POND online database. Results: There were 755 children identified with relapsed disease. Median time to relapse from original diagnosis was 1.66 (0.8-3.1) years, most occurring during (53.9%) or following (24.9%) maintenance chemotherapy. Most relapses were in the bone marrow (63.1%). Following the initial relapse, subsequent EFS was 21.9 +/- 1.7%, and OS was 28.2 +/- 1.9% at three years. In multivariable analysis, better post-relapse survival was associated with age

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  • S Marjerrison

  • F Antillion

  • L Fu

  • R Vasquez

  • L Sung

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