Inclan-Alarcon SI, Riviello-Goya S, Teran-De-la-Sancha K, Fierro-Angulo OM, Acosta-Medina AA, Demichelis-Gomez R, Bourlon C. Induction-related mortality in adolescents and young adults with acute lymphoblastic leukemia in a resource-limited setting: do treatment-related complications create more impact than disease biology?
Blood Res 2022;
57:29-33. [PMID:
35197368 PMCID:
PMC8958371 DOI:
10.5045/br.2021.2021058]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022] Open
Abstract
Background
Acute lymphoblastic leukemia (ALL) is a malignant clonal bone marrow disorder with a high mortality rate during the initial therapy. This retrospective study aimed to describe and analyze the risk factors and causes of induction-related mortality (IRM) in an adolescent and adult ALL population treated in a low- and middle-income country.
Methods
From 2009 to 2016, a total of 167 patients were included, of which 50.9% were male with a median age of 28 years. B-immunophenotype represented 97.6%, and high-risk cytogenetics were present in 23.3%. During induction therapy, 91% had at least 1 complication, most of which were infectious, with an IRM of 12%.
Results
Factors associated with increased mortality rate were central nervous system (CNS) status [CNS-3: hazard ratio (HR) 3.029; 95% confidence interval (CI), 0.79-11.49; P=0.103 and CNS-2: HR, 9.98; 95% CI, 2.65-37.65; P=0.001] and dialysis requirement (HR, 9.15; 95% CI, 2.44-34.34; P=0.001).
Conclusion
Our study confirms that ALL patients treated in resource-constrained settings have high rates of IRM, mainly attributed to advanced disease and high tumor burden at diagnosis.
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