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?
- Author:
Sergio I. INCLAN-ALARCON
1
;
Santiago RIVIELLO-GOYA
;
Kevin TERAN-DE-LA-SANCHA
;
Oscar M. FIERRO-ANGULO
;
Aldo A. ACOSTA-MEDINA
;
Roberta DEMICHELIS-GOMEZ
;
Christianne BOURLON
Author Information
- Publication Type:ORIGINAL ARTICLE
- From:Blood Research 2022;57(1):29-33
- CountryRepublic of Korea
- Language:English
-
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.
