TY - JOUR
T1 - Childhood acute lymphoblastic leukemia in the Middle East and neighboring countries
T2 - A prospective multi-institutional international collaborative study (CALLME1) by the Middle East Childhood Cancer Alliance (MECCA)
AU - Al-Mulla, Naima A.
AU - Chandra, Prem
AU - Khattab, Mohammed
AU - Madanat, Faris
AU - Vossough, Parvaneh
AU - Torfa, Eyad
AU - Al-Lamki, Zakiya
AU - Zain, Gamal
AU - Muwakkit, Samar
AU - Mahmoud, Salah
AU - Al-Jassmi, Abdulrahman
AU - Tuncer, Murat
AU - Al-Mukharraq, Hussein
AU - Barsaoui, Sihem
AU - Arceci, Robert J.
AU - Howard, Scott C.
AU - Kulozik, Andreas E.
AU - Ravindranath, Yaddanapudi
AU - Reaman, Gregory H.
AU - Farranoush, Mohammad
AU - Alnasser, Abdullah A.
PY - 2014/8
Y1 - 2014/8
N2 - Background: Little is known about childhood ALL in the Middle East. This study was undertaken by MECCA as initial efforts in collaborative data collection to provide clinical and demographic information on children with ALL in the Middle East. Procedure: Clinical and laboratory data for patients with ALL between January 2008 and April 2012 were prospectively collected from institutions in 14 Middle East countries and entered into a custom-built-database during induction phase. All laboratory studies including cytogenetics were done at local institutions. Results: The 1,171 voluntarily enrolled patients had a mean age of 6.1±3.9 years and 59.2% were boys. T-ALL represented 14.8% and 84.2% had B-precursor ALL. At diagnosis, 5.6% had CNS disease. The distribution of common genetic abnormalities reflected a similar percentage of hyperdiploidy (25.6%), but a lower percentage of ETV6-RUNX1 translocation (14.7%) compared to large series reported from Western populations. By clinical criteria, 47.1% were low/standard risk, 16.9% were intermediate risk, and 36% were high risk. Most patients received all their care at the same unit (96.9%). Patients had excellent induction response to chemotherapy with an overall complete remission rate of 96%. Induction toxicities were acceptable. Conclusions: This first collaborative study has established a process for prospective data collection and future multinational collaborative research in the Middle East. Despite the limitations of an incomplete population-based study, it provides the first comprehensive baseline data on clinical characteristics, laboratory evaluation, induction outcome, and toxicity. Further work is planned to uncover possible biologic differences of ALL in the region and to improve diagnosis and management. Pediatr Blood Cancer 2014; 61:1403-1410.
AB - Background: Little is known about childhood ALL in the Middle East. This study was undertaken by MECCA as initial efforts in collaborative data collection to provide clinical and demographic information on children with ALL in the Middle East. Procedure: Clinical and laboratory data for patients with ALL between January 2008 and April 2012 were prospectively collected from institutions in 14 Middle East countries and entered into a custom-built-database during induction phase. All laboratory studies including cytogenetics were done at local institutions. Results: The 1,171 voluntarily enrolled patients had a mean age of 6.1±3.9 years and 59.2% were boys. T-ALL represented 14.8% and 84.2% had B-precursor ALL. At diagnosis, 5.6% had CNS disease. The distribution of common genetic abnormalities reflected a similar percentage of hyperdiploidy (25.6%), but a lower percentage of ETV6-RUNX1 translocation (14.7%) compared to large series reported from Western populations. By clinical criteria, 47.1% were low/standard risk, 16.9% were intermediate risk, and 36% were high risk. Most patients received all their care at the same unit (96.9%). Patients had excellent induction response to chemotherapy with an overall complete remission rate of 96%. Induction toxicities were acceptable. Conclusions: This first collaborative study has established a process for prospective data collection and future multinational collaborative research in the Middle East. Despite the limitations of an incomplete population-based study, it provides the first comprehensive baseline data on clinical characteristics, laboratory evaluation, induction outcome, and toxicity. Further work is planned to uncover possible biologic differences of ALL in the region and to improve diagnosis and management. Pediatr Blood Cancer 2014; 61:1403-1410.
KW - Induction
KW - Leukemia
KW - MECCA
KW - Pediatric
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UR - http://www.scopus.com/inward/citedby.url?scp=84901988987&partnerID=8YFLogxK
U2 - 10.1002/pbc.25031
DO - 10.1002/pbc.25031
M3 - Article
C2 - 24648275
AN - SCOPUS:84901988987
SN - 1545-5009
VL - 61
SP - 1403
EP - 1410
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 8
ER -