The clinical analyse of the patients with acute lymphoblastic leukemia between the years 2002 -2010

Objective: To establish demographical features, clinical and prognostic factors of acute lymphoblastic leukemia (ALL) patients who were treated with Hyper CVAD chemotherapy regimen in Dokuz Eylül University School of Medicine Hematology Department and to evaluate their treatment response and survival rates, retrospectively.Materials and Methods: ALL patients treated with Hyper CVAD chemotherapy regimen in Dokuz Eylul University Hematology Department between 2002 and 2010 are included in the study. Follow up and treatment data are obtained from hospital database system and patient files.Results: Out of 44 patients included in the study, 37 were diagnosed as ALL and 7 were diagnosed as ALL and LL (lymphoblastic lymphoma). Mean age was 34,6 (17-61), 38,1% was female (14 patients) and 68,2% was male (30 patients). 32 patients (72,7%) were in high risk group and risk profile of 12 patients could not be calculated (27,3%). Mean ECOG performance during initial diagnosis was 1,7 (0-4). Most common cytogenetic abnormality was presence of Philadelpha chromosome (9,1%). 64,3 % of patients was in B cell immunophenotype and 52,8% had L2 morphology. 12 (27,3%) out of 44 patients included were alive whereas 32 (72,7%) patients were dead during follow up. Allogeneic bone marrow transplantation was performed in 5 patients, 4 of whom from a realtive and 1 from a non relative donour. In remission induction therapy with Hyper CVAD regimen, 87,5% of patients had gone remission but in 12,5% of patients remission could not be achieved. Splenomegaly, hepatomegaly and presence of mediastinal mass did not affect the remission rates. (respectively p=1, p=0,373, p=0,427). Remission ratio for patients over 35 was 83,3% and for patients 35 and under was 90,9% (p=0,642). Remission ratio for patients with leukocyte count of 30,000 and under at diagnosis was 100% whereas for patients with over 30,000 it was 58,3% (p=0,01). Overall survival rate was 27,3% and overall survival duration was 26,41 months (3-79 months), median was 15 months. Mean disease free survival duration wasc 17,02 months (1-78 months) and disease free survival rate was 32,43%. In high risk group detah rate was 75%, survival rate was 25% and in patients for whom risk profile could not be calculated, detah rate was 66,7% and survival rate was 33,3% (p=0,704).Discussion: Results of our study were similar as other studies in literature. We think that present regşmens are inadequate for ALL patients who have overall survival rate 27-48% and new therapy regimens are needed.Keywords: ALL, Hyper CVAD