Survival Outcome of Childhood Acute Lymphoblastic Leukemia in India: A Resource-Limited Perspective of More Than 40 Years

The outcome of childhood acute lymphoblastic leukemia in India has been inferior to more than 80% cure rates in developed nations. This study was done to analyze the outcome of acute lymphoblastic leukemia in India over 4 decades. There has been a gradual improvement in survival rates of up to >70% in some centers along with a decline in relapse and mortality. However, these results cannot be generalized to the entire nation. There is a crying need to address treatment abandonment, take quality improvement, educational and financial initiatives; cooperative research into risk factors and disease biology, and the implementation of risk stratification along with the assessment of response to therapy.

[1]  B. George,et al.  Treatment of children with acute lymphoblastic leukemia in India using a BFM protocol , 2008, Pediatric blood & cancer.

[2]  R. Marwaha,et al.  Pattern of Mortality in Childhood Acute Lymphoblastic Leukemia: Experience From a Single Center in Northern India , 2010, Journal of pediatric hematology/oncology.

[3]  T. Eden,et al.  The problem of treatment abandonment in children from developing countries with cancer , 2007, Pediatric blood & cancer.

[4]  S. Rajajee,et al.  Survival of childhood acute lymphoblastic leukemia: experience in Chennai. , 1999, Journal of tropical pediatrics.

[5]  K. R. Rajalekshmy,et al.  Prognostic variables and survival in pediatric acute lymphoblastic leukemias: cancer institute experience. , 1996, Pediatric hematology and oncology.

[6]  A. Trehan,et al.  Survival outcome in childhood ALL: Experience from a tertiary care centre in North India , 2009, Pediatric blood & cancer.

[7]  R. Swaminathan,et al.  Childhood cancers in Chennai, India, 1990–2001: Incidence and survival , 2008, International journal of cancer.

[8]  S. Pai,et al.  Survival of childhood acute lymphoblastic leukemia: results of therapy at Tata Memorial Hospital, Bombay, India. , 1996, Leukemia & lymphoma.

[9]  G. Mukherjee,et al.  Descriptive epidemiology of childhood cancers in Bangalore, India , 1996, Cancer Causes & Control.

[10]  R. Naithani,et al.  Thiopurine S-methyltransferase gene polymorphism and 6-mercaptopurine dose intensity in Indian children with acute lymphoblastic leukemia. , 2010, Leukemia research.

[11]  L. Mathews,et al.  Treating leukemia in a resource poor setting. , 2008, Indian pediatrics.

[12]  S. Advani,et al.  Acute lymphoblastic leukemia: End‐result analysis of treatment and prognostic factors in Indian patients , 1983, American journal of hematology.

[13]  I. Magrath,et al.  Pattern of Relapse in Childhood ALL: Challenges and Lessons From a Uniform Treatment Protocol , 2010, Journal of pediatric hematology/oncology.

[14]  S. Pai,et al.  Four‐agent induction/consolidation therapy for childhood acute lymphoblastic leukemia: An Indian experience , 1992, American journal of hematology.

[15]  D. Venzon,et al.  Treatment of acute lymphoblastic leukaemia in countries with limited resources; lessons from use of a single protocol in India over a twenty year peroid , 2005 .

[16]  J. Downing,et al.  Long-term results of St. Jude Total Therapy studies 11, 12, 13A, 13B and 14 for childhood acute lymphoblastic leukemia , 2009, Leukemia.

[17]  H. Jaworska,et al.  [Leukemia in infants]. , 1959, Pediatria Polska.

[18]  D. Venzon,et al.  Acute lymphoblastic leukemia in India: an analysis of prognostic factors using a single treatment regimen. , 1999, Annals of oncology : official journal of the European Society for Medical Oncology.