Evaluation of demographic, clinical and laboratory findings of patients with acute lymphoblastic leukemia followed up in our clinic between 2010 and 2015

Evaluation of Demographic, Clinical and Laboratory Findings of Patients with Acute Lymphoblastic Leukemia followed up in our Clinic between 2010 and 2015 Introduction and Objective: Acute Lymphoblastic Leukemia (ALL) is the most common type of childhood cancers with a survival rate up to 80% thanks to multiple chemotherapies. This retrospective study aims to screen patients who had been diagnosed with ALL in the Pediatric Hematology-Oncology Department of the Dicle University Faculty of Medicine between 2010 and 2015; and to reveal the mortality rate by evaluating clinical and laboratory findings, immunophenotypic and cytogenetic characteristics, morphologic features of bone marrow, and evaluating chemotherapeutic response. Material and Method: The files of 121 patients who had been diagnosed with Acute Lymphoblastic Leukemia (ALL) and who had been treated with TR-ALL BFM 2000 and ALL-IC-BFM 2009 protocol in the Hematology and Oncology Polyclinic of Dicle University Faculty of Medicine Pediatric Hospital between 2010 and 2015 were screened retrospectively and included in the study. Results: Of the children included in the study, 70.2% was in the 1-6 age group and 47.9% was living in the rural area. The most common symptoms during admission were fever, fatigue, pallor and loss of appetite. The most common physical examination symptom was lymphadenopathy during admission. Of the patients, 41.3% was A Rh +, 34.7% was 0 Rh + and 13.2% was B Rh +. Of the patients, 65.3% had a white blood cell (WBC) count of 0-20,000/mm3, 71.1% had a hemoglobin (HGB) value of 7 g/dl and above and 67.8% had a platelet (PLT) count of 100,000/mm3 and below. t(9,22) and t (4,11) were positive in 3.3% and 0.8% of the patients, respectively. Of the patients, 78.5% was found to be B-ALL and 21.5% was found to be T-ALL. TR-ALL BFM 2000 protocol had been applied in 57% of patients, whereas ALL IC-BFM 2009 protocol had been applied in 43% of patients. The relapse rate of patients was 5.8% and the overall mortality rate was 11.6%. There was no statistically significant difference in terms of gender, white blood cell count, hemoglobin level, platelet count, immunophenotype and mortality. There was a statistically significant difference between the risk group of the patients and the protocol applied and mortality (p<0.05). Of those who lost their lives, 57.1% was high risk group (HRG) patients. And, 71.4% of the patients who lost their lives had been treated with the TR-ALL BFM 2000 protocol. Of the relapses, 71.4% was T-ALL. And, TR-ALL BFM 2000 protocol had been applied in 85.7% of them. There was a statistically significant difference between the immunophenotype and the protocol applied and relapse (p<0.05). Conclusion: Considering the age, gender, clinical findings and laboratory results, results obtained were similar to the studies in the literature. We identified the factors affecting overall survival and relapse in patients. The factors we found were statistically significant. The mortality rate was higher in the patients in the high-risk group. The relapse rate was higher in high-risk group. We found that ALL immunophenotype was effective on mortality and relapse rate. The relapse rate of T-ALL patients was higher than that of B-ALL patients. In addition, the relationship between mortality and relapse and treatment protocol was investigated. We found that mortality and relapse rates were higher in the patients receiving the TR-ALL BFM 2000 treatment protocol compared to the ALL-IC BFM 2009 protocol. The results we found were statistically significant. Keywords: Acute Lymphoblastic Leukemia, Demography, Clinic