CHILDHOOD
ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) AND RELAPSES - OUR EXPERIENCE
Martinova K, Zisovski N, Muratovska O, Glamocanin S, Antevska-Trajkova Z
University Children’s Hospital, Faculty of Medicine, Skopje, R.
Macedonia
Objective and methods: During the period
1979-1997, 130 children with ALL and relapses were diagnosed and treated at
the Pediatric Clinic - Oncology Department in Skopje. The initial therapy
and the therapy for relapses were administered according to different
regiments that were used in the period when leukemia and relapses were
diagnosed. The location of the first leukemic relapse in the evaluated
group is as following: 89 children developed first BMR, 24 children CNSR, 8
children Testicular and 9 children combined relapses.
Results: The outcome of the initial and reinduction
therapy in the group of children with BMR demonstrated significantly lower
percentage of second CR (47,1%) and third CR (10,3%) compared to the first
CR (96,9%). A high percentage of reinducion failure: first (37,1%) and
second (71,8%), and appearance of a high number of relapses during the
therapy. The short duration of the first CCR, which was confirmed in our
study as the most important prognostic factor, explains the unsuccessful
evolution in the group of the children with BMR.
Conclusions: The CNSR and combined relapses are with a similar
unsuccessful evolution as the BMR with a median overall survival time of
1-2 years. Our study confirmed the best prognosis for the group of children
with TR with a survival rate of 90% for a 3 years time period.