Outcomes of childhood acute lymphoblastic leukemia treated with the
modified St Jude Total Therapy XV Protocol: a single-center experience
in Turkey
Abstract
Background When developed countries are considered; in the treatment of
childhood acute lymphoblastic leukemia (ALL), the survival rate has
reached 90% in recent years. We aimed to examine the survival rate and
the factors that may affect this rate, especially in our patients
treated with the ST Jude Total Therapy XV protocol. Procedures Pediatric
patients aged 1-18 years, who were treated at our hospital and completed
their treatment between January 2011 and December 2018, and only pre-B
and T-cell leukemias treated with the St Jude Total Therapy XV protocol
were included in the study. Results The 5-year event-free survival (EFS)
and overall survival (OS) were 78.3% and 80%. We observed that some
factors that affect survival, such as gender, blastic type, risk group,
and number of WBCs, did not affect survival in our study. Even though it
is known that the female gender has better EFS, in our study, the
survival of girls was found to be lower than boys. Tragically, we
observed that the most common cause of death (20/23, 87%) was infection
and infection-related causes. Conclusions The primary purpose of the St
Jude Total XV treatment protocol is to monitor minimal residual disease
(MRD) and to guide treatment according to MRD results. It is also the
removal of radiotherapy from treatment protocols by adding additional
intra-thecal treatments (ITT). However, unfortunately, if we cannot
protect our patients from infection and other related factors, the
factors that make a difference in treatment become meaningless.