Improvement in Survival Outcomes of Acute Lymphoblastic Leukemia Patients Treated With Berlin-Frankfurt-Munster 76/79 Protocol

Abstract

Introduction: Acute lymphoblastic leukemia (ALL) is a malignancy of the white blood cells and lymphoid lines of hematopoietic cells in the blood and bone marrow while lymphomas mostly involve the lymph nodes. This study showed the response rate of ALL treated with BFM (Berlin-Frankfurt-Munster) 76/79 protocol.

Aims & Objectives: To study the effects of WBC (White Blood Cells), age, and treatment protocols on the survival of ALL patients to BFM 76/79 protocol and other chemotherapy protocol.

Place and duration of study: 6 months retrospective study on 2015-2017 indoor patient data from INMOL Hospital Lahore, Pakistan.

Material & Methods: Data of 129 patients was assessed for eligibility, and 84 patients of ALL  selected. Clinical information of patients regarding Gender, Age, WBC, Fever, Hepatosplenomegaly, Lymphadenopathy, Bleeding, Bone Pain, Immunophenotype, Relapse, Death, and survival rates were recorded. Patients were grouped according to Age, WBC, Gender, and Immunophenotype. Patients were treated with BFM 76/79 Protocols and the remaining patients were treated with other protocols (CALGB, FLAG-TDA, Hyper-CVAD, EURO, COG, T-Cell ALL protocol, and ALL protocol 9111).

Results: Out of 84 patients, 55 (65.5%) patients were treated with Berlin-Frankfurt-Munster 76/79 protocol and the remaining 20 (23.81%) patients with other protocols. After the end of induction 64 (73.8%) patients achieved complete remission and 5 (5.95%) patients did not achieve Remission.

Conclusion:  Response rate of ALL (Acute Lymphoblastic Leukemia) patients treated with BFM 76/79 protocol was better than other protocols and possibly when risk adapted for male gender, WBC > 50 x 10⁹/L and age> 30 years.