Mega-Analysis of 50 Years of Diagnosis and Therapy of Childhood Acute Lymphoblastic Leukemia in Bydgoszcz, Poland: From Prednisolone Therapy to Microarray Studies

Background: The beginnings of pediatric oncology in Bydgoszcz, Poland dates back to the year 1958. The first patient was treated with prednisolone only.

Objective: Analysis of results of childhood acute lymphoblastic leukemia therapy in Bydgoszcz region in 1958–2008.

Patients and methods: A total number of 570 children were diagnosed and treated over the period of 50 years, including: 215 children treated with different drugs and combinations in 1958–1972, 49 children treated with Memphis V–VII protocols in 1976–1983, 114 children treated with ALL-BFM83 or ALL-BFM86 protocols in 1983– 1995 and 192 children treated with ALL-BFM90, New York I–II or ALL-IC-2002 between 1995–2008.

Results: A number of patients with „events” in respective time periods was: 205/215 (95.3%, in 1958–1972); 44/49 (89.8%, in 1976–1983), 54/114 (47.4%, in 1983–1995), 56/192 (29.2%, in 1995–2008). The values of 5-year pEFS in consecutive therapeutic periods were: p=0.012±0.008 (1958–1972), p=0.102±0.043 (in 1976–1983), p=0.526±0.047 (in 1983–1995), p=0.700±0.037 (in 1995–2008) (p<0.0001). A median survival time was, respectively: 0.8 year (for patients treated in 1958–1972); 1.8 year (in1976–1983); 5.7 years (in 1983–1995); 7.4 years (for patients treated in 1995–2008).

Conclusions: Complex therapy based on international strategy of multiagent total therapy and supportive care, has led to an improved long-term survival in childhood ALL in Bydgoszcz region, Poland, from 1% in sixties up to 70% nowadays

Figure 1.

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pEFS in ALL with respect to time period

Figure 1.

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pEFS in ALL with respect to time period

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