Retrospective evaluation of compliance to treatment protocol schedules and it's effect to disease outcomes in acute lymphoblastic leukemia pati̇ents

Objective: In this study, it was aimed to evaluate the compliance to treatment protocol contents and protocol schedules with the demographic, clinical and laboratory characteristics of acute lymphoblastic leukemia (ALL) patients retrospectively, and to determine the effect on survival of disease. Materials and Methods: The study was held retrospectively among the pediatric patients diagnosed with acute lymphoblastic leukemia, which had been followed in Ege University Pediatric Hematology Unit between May 2005 and April 2013. After receiving the files of the patients, demographic, morphological and clinical data, types of treatment, delay in treatment and schedules were recorded. In analysis, descriptive statistics, chi-square, Fisher's exact test, Kaplan-Meier analysis and Cox regression analyzes were used. In instances, which p <0.05, was considered statistically significant. Results: The average age of the patients were 82.2 months, consisting 58,1% male patients. 87.9% of the patients were PreB Cell ALL, 40,7% were standart risk group (SRG), 50,8% were receiving TRALL BFM 2000 protocol. In 81.3% of the patients, blast count in peripheral blood was below 1000/μL at day 8. And in 19.3%, t(12; 21) was present. Deviations from treatment schedule were detected in 44.4% of all treated patients. Most frequent deviations from treatment were in Protocol I Phase II stage. No relationship was found in this study, between survival and deviation in timing of treatment. Average life expectancy was found higher in patients with less than 1000/μL blasts in peripheral blood at day 8 of treatment. No relationship was found between risk groups, treatment outcomes, deviations from the treatment and life expectancy. No relationship was found, between deviations from the treatment timing and prognosis in this study. However, it was concluded that, patients with less than 1000/μL blasts, have better prognosis. The prospective studies evaluating the relationship between treatment outcomes and deviation in treatment schedules, can show the relationship between deviations from treatment schedule and prognosis more clearly. Keywords: ALL, Prognosis, Treatment, Timing, Deviation, Pediatrics