RESUMEN
Our investigation was concerned with effectiveness of infantile neuroblastoma treatment in Belarus and dependence of prognosis on extent of radical surgery. The study involved 115 patients with morphologically confirmed diagnosis of primary tumor who were treated at the Center (1997-2007). Ten-year overall and relapse-free survival rates for favorable prognosis, stage I, II, III, were 1.00 and 0.94 +/- 0.04, respectively. They were significantly higher than those for intermediate (0.70 +/- 0.09 and 0.61 +/- 0.09) or high risk (0.32 +/- 0.08 and 0.27 +/- 0.08), respectively, (p < or = 0.01). The results for radical local surgery were better: 5-year relapse-free survival--0.82 +/- 0.09 as compared with subtotal excision (0.62 +/- 0.12) and biopsy (0.5 +/- 0.25) among patients older than 12 months. Autologous stem cell transplantation (ASCT) was followed by significant improvement: 6-year overall and relapse-free survival (stage IV) (0.5 +/- 0.12 and 0.38 +/- 0.12, respectively) as compared those without ASCT (0.12 +/- 0.08 and 0.1 +/- 0.08), respectively, (p < or = 0.01). The main cause of death after ASCT was relapse. Poor results following post-ASCT treatment of stage IV tumor should be improved by more effective detection and removal of tumor cell harvest.
Asunto(s)
Neuroblastoma/mortalidad , Neuroblastoma/terapia , Factores de Edad , Niño , Preescolar , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Lactante , Estimación de Kaplan-Meier , Masculino , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Neuroblastoma/patología , Neuroblastoma/cirugía , Pronóstico , República de Belarús/epidemiología , Trasplante de Células Madre , Trasplante Autólogo , Resultado del TratamientoAsunto(s)
Leucemia/epidemiología , Linfoma/epidemiología , Adolescente , Factores de Edad , Linfoma de Burkitt/epidemiología , Niño , Preescolar , Interpretación Estadística de Datos , Femenino , Enfermedad de Hodgkin/epidemiología , Humanos , Lactante , Recién Nacido , Leucemia Mieloide Aguda/epidemiología , Modelos Lineales , Linfoma no Hodgkin/epidemiología , Masculino , Distribución de Poisson , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiología , Sistema de Registros , República de Belarús/epidemiología , Factores SexualesRESUMEN
The data on examination and treatment of 39 children with T-cell acute lymphoblastic leukemia (T-ALL) were assessed; all patients received ALL BFM-90-M treatment. The fraction of children with T-ALL among ALL patients in Belarus was 12.2% (pre-T-ALL--15, cortical T-ALL--46 and mature T-ALL--23%). Also, a subtype of T-ALL with atypical expression of markers was identified (13%). Overall 7-year survival in T-ALL patients was 47(20%). The worst prognosis was recorded in the T-ALL subgroup with atypical expression of markers (p < 0.001 as compared with the other subgroups). As for outcome--from best to worst, T-ALL subtypes ranged as follows: cortical T-ALL, mature T-ALL, pre-T-ALL and T-ALL with atypical expression of markers.