Comparison of Capizzi and High-dose Methotrexate Approaches in the Treatment of Pediatric B-cell Acute Lymphoblastic Leukemia
JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY, cilt.47, sa.2, ss.67-73, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 47 Sayı: 2
- Basım Tarihi: 2025
- Doi Numarası: 10.1097/mph.0000000000002995
- Dergi Adı: JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Sayfa Sayıları: ss.67-73
- Anahtar Kelimeler: ALL, B-ALL, capizzi methotrexate, high dose methotrexate
- İstanbul Üniversitesi Adresli: Evet
Özet
Childhood cancers, with leukemia at the forefront, comprise 97% acute leukemia and 3% chronic leukemia, with 75% of acute leukemias being of lymphoblastic origin. Over the past 50 years, survival rates have witnessed a remarkable increase, progressing from around 10% to achieving cure rates exceeding 90% in certain childhood ALL subgroups with the advent of combined therapies. Between 1999 and 2018, a total of 123 patients diagnosed with B-ALL were initially identified, but after applying exclusion criteria, 105 patients were included in the evaluation, who were treated with COG protocols at our center. The mean follow-up duration for patients was determined to be a median of 74 months (min to max: 2 to 228 months). When the cases were evaluated at the end of the study, 59 of 59 individuals in the standard risk group (100%), 21 of 26 individuals in the high-risk group (80.7%), and 14 of 20 individuals in the very high group (70%) were alive. Patients were categorized into 4 groups based on the methotrexate (MTX) doses they received during Phase 3 and Phase 5 of treatment. Event-free survival and overall survival were evaluated among these groups. It was observed that patients in the standard-risk group had significantly higher event-free and overall survival rates. However, no significant difference was found in survival rates when evaluated based on the treatment groups each risk group received by the patients.