ĐÁNH GIÁ HIỆU QUẢ ĐIỀU TRỊ BỆNH BẠCH CẦU CẤP DÒNG LYMPHO B Ở TRẺ EM CÓ ĐỘT BIẾN CHUYỂN ĐOẠN t(1;19)

Abstract

Objective: To evaluate of biological characteristics, long-term outcome, survival time and complications of t(1;19) mutation childhood B-cell acute lymphoblastic leukemia treatment by using FRALLE 2000 protocol. Methods: A retrospective case series study of 38 patients met sample’s criterias with median age of 5 years old, treated with FRALLE 2000 protocol at Pediatric departments 1 and 2 – Blood Transfusion and Hematology hospital  from 2010 to 2020. Results: Additional cytogenetic abnormalities were fairly common (39.5%). 89.5% of cases did not have Leukemia-Associated-Immunophenotypes (LAIPs) to detect Minimal Residual Disease (MRD) by multiparameter flow cytometry. All patients achieved complete remission after induction therapy. Overall survival (OS) and the Event-free survival (EFS) after 5 years were 84.4% and 70.9%. The cumulative incidence of relapse was 27.1%. There was no significant difference in OS, EFS between t(1;19) alone and t(1;19) with other abnormalities group. End-induction MRD was the most powerful prognostic factor, indicated that significant differences in EFS (p<0,01). Infectious complications are prominent, encountered at all stages of treatment. Treatment-Related Mortality was 2.6% (one case), due to paralytic ileus and septic shock. Conclusion: End-induction MRD positive has increased the risk of relapse. However, the majority did not have LAIPs to monitor MRD by FC, so molecular biology method is the most important to measure MRD. With the FRALLE 2000 protocol applied at the Blood Transfusion and Hematology hospital, the treatment was quite effective, equivalent to result of the general treatment of childhood acute lymphoblastic leukemia. It has been shown that t(1;19) translocation is not an adverse prognostic factor.