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Outcome of Modified St Jude Total Therapy 13A for Childhood Acute Lymphoblastic Leukemia in the Southeast Region of Turkey

Koc, Ahmet MD; Aycicek, Ali MD; Ozdemir, Zeynep C. MD; Soker, Murat MD; Varma, Mustafa MD

Journal of Pediatric Hematology/Oncology: January 2013 - Volume 35 - Issue 1 - p 36–41
doi: 10.1097/MPH.0b013e318271f43f
Original Articles

Objective: To fill the gap in the current data on childhood acute lymphoblastic leukemia (ALL) in low-income and middle-income countries.

Methods: This study included 106 children between the ages of 1 and 17 years with newly diagnosed ALL monitored between 1999 and 2010. All the patients were treated with the modified St Jude Total 13A treatment plan at the Pediatric Hematology Clinic at Harran University.

Results: Sixty-eight (64.2%) patients were boys and 38 (35.8%) were girls. The median age at diagnosis was 5.9±3.7 years. Thirty-eight (35.8%) children were classified as standard risk, 53 (39.3%) were intermediate risk, and 15 (14.2%) were high risk. Thirteen (12.3%) children died in induction before the remission date (43 d of remission induction). Of all the 93 (100%) patients who completed remission induction therapy and whose bone marrow were in remission, 5 (4.7%) had a bone marrow relapse, 1 (0.9%) had a retinal relapse, and 5 (4.7%) had secondary acute myeloid leukemia. At a median follow-up of 44 months (range, 0.36 to 135.5 mo), the estimated 5-year overall survival and event-free survival were 77.4±5% and 68.9±6.5%, respectively. The estimated 5-year overall survival for boys and girls was 76.5±6% and 65.8±8%, respectively (P=0.182).

Conclusions: St Jude Total 13A treatment protocols to treat childhood ALL can be successfully adapted, which suggests that such an approach may be useful in low socioeconomic regions; however, it should be noted that secondary leukemia can occur at a high rate.

*Pediatric Hematology Department, Medical Faculty, Harran University

§OSM Middle East Hospital, Sanliurfa

Pediatric Hematology Department, Adana Numune Training and Research Hospital, Adana

Pediatric Hematology/Oncology Department, Medical Faculty, Dicle University, Diyarbakir, Turkey

The authors declare no conflict of interest.

Reprints: Ali Aycicek, MD, Pediatric Hematology Department, Medical Faculty, Harran University, Sanliurfa 63050, Turkey (e-mail:

Received September 25, 2011

Accepted March 29, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.