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NO BLASTS AT DAY 8 IS BETTER THAN MORE IN CORTICO-SENSITIVE ACUTE LYMPHOBLASTIC LEUKEMIA OF CHILDREN

PF193

Frikha, I.1; Turki, I.1; Medhaffer, M.1; Hdijji, S.1; Ben Amor, I.1; Charfi, M.1; Kassar, O.1; Ghorbel, M.1; Kallel, F.1; Elloumi, M.1

doi: 10.1097/01.HS9.0000558988.46333.18
Poster Session I: Acute lymphoblastic leukemia - Clinical
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1Hematology Department, Hedi Chaker Hospital, Sfax, Tunisia, Sfax, Tunisia

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Background:

Acute lymphoblastic leukemia (ALL) had a good prognostic in children and young adults. However, some parameters were predictive of a worse outcome, particularly the poor response to prephase.

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Aims:

We analysed in this study the impact of persistent blasts at day 8 of pre-phase in cortico-sensitives patients with ALL.

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Methods:

Between january 2000 and December 2015, we retrospectively analysed the data of 264 children and young adults treated according the EORTC 58951 protocol. Cortico-sensitivity (Cs) was considered if peripheral blast count is less than 1000/mm3 at day 8 of pre-phase. The group of cortico-sensitives ALL was subdivided on two subgroups: the first with no blasts at day 8 (Cs = 0) and the second with more (Cs≠0). We analysed the impact of cortico-sensitivity on complete remission (CR), relapse and survival (overall survival (OS), event free survival (EFS) and disease free survival (DFS)).

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Results:

One hundred ninety two children and 72 young adults were treated according to the EORTC 58951 protocol. Median age was 10 years (1 to 30 years). Sex ratio was 1,5. B and T phenotype were observed in respectively 64 and 36% of cases. The ALL were stratified in low risk (11 patients), average risk (182 patients), and high risk (71 patients). Two hundred and nine patients (79%) were cortico-sensitive, among them 150 patients (72%) had no blast at day 8 of pre-phase. The therapeutics results in our study and into the two groups of cortico-sensitivity were shown in this table:

Figure

Figure

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Summary/Conclusion:

Cortico-sensitivity is one of several parameters that predict good outcome in ALL. Moreover, our study showed that no blasts in peripheral blood smears at day 8of prephase can be considered a good first marker of early blastic clearance and good outcome. In fact, this parameter does not discussed previously in the literature.

Copyright © 2019 The Authors. Published by Wolters Kluwer Health Inc., on behalf of the European Hematology Association.