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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Cure rates of childhood acute lymphoblastic leukemia in Lithuania and the benefit of joining international treatment protocol

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Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Clinic for Paediatric and Adolescent Medicine, Juliane Marie Centre, University Hospital Rigshospitalet, Copenhagen, Denmark
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Laboratory Diagnostics Centre, Vilnius University Hospital Santariškių Clinics, Vilnius, Lithuania
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Physiology, Biochemistry, and Laboratory Medicine Department, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Hematology, Oncology, and Transfusion Medicine Center, Vilnius University Hospital Santariškių Clinics, Vilnius, Lithuania
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Institute of Gynaecology, Obstetrics and Paediatrics, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
*
Author to whom correspondence should be addressed.
Medicina 2014, 50(1), 28-36; https://doi.org/10.1016/j.medici.2014.05.005
Published: 6 June 2014
Background: Childhood acute lymphoblastic leukemia (ALL) represents the largest group of pediatric malignancies with long-term survival rates of more than 80% achieved in developed countries. Epidemiological data and survival rates of childhood ALL in Lithuania were lacking. Therefore, the aim of this study was to analyze the population-based long-term treatment results of childhood ALL in Lithuania during 1992–2012.
Materials and methods: Data of all 459 children with T-lineage and B-cell precursor ALL treated in Lithuania from 1992 to 2012 were collected and analyzed. Results were compared among four time-periods: 1992–1996 (N = 132), 1997–2002 (N = 136), 2003–2008 (N = 109) and 2009–2012 (N = 82).
Results: The incidence of childhood ALL in Lithuania was 3.2–3.6 cases per 100 000 children per year during the study period. Five-year probability of event-free survival increased from 50% 4% in 1992–1996 to 71% ± 4% in 2003–2008 (P < 0.001). Five-year cumulative incidence of relapses reduced from 27% ± 4.5% in 1992–1996 to 14% ± 3.6% in 2003–2008 (P = 0.042). After introduction of high-dose methotrexate of 5 g/m2, cumulative incidence of CNSinvolving relapses reduced from 17% ± 3.9% in 1992–1996 to 1% ± 1.0% in 2003–2008 (P < 0.001). Trend for further improvement in survival was seen in 2009–2012 when Lithuania joined international the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL-2008 treatment protocol.
Conclusions: Cure rates of childhood ALL in Lithuania are improving steadily and are now approaching those reported by the largest international study groups. The reasons for such a positive effect are both better financial support for treatment of children with cancer in Lithuania and international collaboration with joining international treatment protocol for childhood ALL.
Keywords: Acute lymphoblastic leukemia; Children; Event-free survival; Cumulative incidence of relapses; International collaboration Acute lymphoblastic leukemia; Children; Event-free survival; Cumulative incidence of relapses; International collaboration
MDPI and ACS Style

Vaitkevičienė, G.; Matuzevičienė, R.; Stoškus, M.; Žvirblis, T.; Ragelienė, L.; Schmiegelow, K. Cure rates of childhood acute lymphoblastic leukemia in Lithuania and the benefit of joining international treatment protocol. Medicina 2014, 50, 28-36.

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