Title White blood cell count at diagnosis of acute lymphoblastic leukemia as a prognostic factor in children treated in Lithuania and the Nordic countries /
Translation of Title Pradinio leukocitų skaičiaus prognostinė reikšmė gydant ūmine limfoblastine leukemija sergančius vaikus Lietuvoje ir Šiaurės šalyse.
Authors Vaitkevičienė, Goda Elizabeta
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Pages 143
Keywords [eng] acute lymphoblastic leukemia ; children ; white blood cell count ; survival
Abstract [eng] The thesis is based on three studies in which data on children with acute lymhpblastic leukemia (ALL) treated in Lithuania or the Nordic countries were analyzed. Study I. Epidemiological and survival data of 459 children treated in Lithuania in 1992-2012 were analyzed. Children with ALL were included for the first time into international clinical trial that was conducted by pediatric oncologists in the Nordic countries. This resulted in survival improval of childhood ALL by 20% reaching results reported by large international childhood ALL study groups. Study II. Study of 2636 childhood ALL patients treated in the Nordic countries in 1992-2008 revealed significant differences in white blood cell (WBC) distribution both among different biological ALL subsets defined by immunophenotype or cytogenetical aberrations of leukemic blasts, and among patients of different age or gender. WBC remained as a risk factor to have a significantly poorer prognosis for patients with a WBC ≥100 x 109/L, but only among slow-responding patients. Study III. A population-based multicenter study of 221 children aged <15 y. with ALL and WBC ≥200x109/L at diagnosis treated in Lithuania and the Nordic countries were analyzed for early mortality and the impact of initial treatment strategy to survival. The Nordic/Baltic guidelines for initial treatment of ALL patients with hyperleukocytosis and a high risk for the development of tumor lysis syndrome (WBC ≥100 x 109/L) were conducted.
Type Doctoral thesis
Language English
Publication date 2013