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Volume 16, Issue 3 (6-2026)
Iran J Ped Hematol Oncol 2026, 16(3): 909-921 |
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Ethics code: EHD/R/res.ec_app.01 (Evercare Hospital Dhaka Ethics Committee)
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Saleh A J M, Haq Q S, Rahman T, Chawdhury M U. Survival Outcomes and Prognostic Indicators in Pediatric Acute Lymphoblastic Leukemia: A Study in a Tertiary Care Setting from Bangladesh. Iran J Ped Hematol Oncol 2026; 16 (3) :909-921
URL: http://ijpho.ssu.ac.ir/article-1-996-en.html
URL: http://ijpho.ssu.ac.ir/article-1-996-en.html
Department of Hematology and Stem Cell Transplant Evercare Hospital & Senior Consultant & Coordinator, Department of Hematology and Stem Cell Transplant Evercare Hospital, Bashundhara R/A, Dhaka 1229, Bangladesh
Abstract: (33 Views)
Background: Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Survival outcomes are significantly higher in high-thiess to diagnostics and standardized therapy contributes to poor prognosis. This study evaluated survival patterns and prognostic indicators in pediatric ALL patients treated at a tertiary care center in Bangladesh.
Materials and Methods: A retrospective cohort of 36 pediatric ALL patients treated between March 2016 and March 2024 was analyzed. Overall survival (OS) and event-free survival (EFS) were estimated using the Kaplan–Meier method. Prognostic indicators included age, white blood cell count, minimal residual disease (MRD) status, CD20 expression, risk classification, and Day 8 steroid response. Associations with MRD clearance were tested using Fisher’s exact and Mann– Whitney U tests. Risk differences with 95% confidence intervals were calculated for subgroup comparisons.
Results: MRD clearance (<0.01%) at the predefined analytic endpoint was achieved in 66.7% of patients. Clearance was more frequent in standard-risk than high-risk patients (85.71% vs. 40.00%; risk difference: 45.71%, 95% CI: 7.60–83.80; p = 0.032) and in CD20-negative compared to CD20-positive patients (86.67% vs. 52.38%; risk difference: 34.33%, 95% CI: 8.60–60.00; p = 0.040). No significant associations were found with initial blast count or steroid response. The 3- and 5-year Kaplan–Meier–adjusted OS and EFS were both 96.55% (95% CI: 77.95–99.51%). One non-relapse death due to infection was recorded.
Conclusion: This study demonstrates favorable survival outcomes among ALL patients at Evercare Hospital pediatric in Bangladesh who completed standardized therapy. MRD clearance was significantly associated with risk classification and CD20 expression, underscoring its utility in risk stratification. Larger, prospective multicenter studies are required to validate these findings and guide treatment strategies in resource-limited settings
Materials and Methods: A retrospective cohort of 36 pediatric ALL patients treated between March 2016 and March 2024 was analyzed. Overall survival (OS) and event-free survival (EFS) were estimated using the Kaplan–Meier method. Prognostic indicators included age, white blood cell count, minimal residual disease (MRD) status, CD20 expression, risk classification, and Day 8 steroid response. Associations with MRD clearance were tested using Fisher’s exact and Mann– Whitney U tests. Risk differences with 95% confidence intervals were calculated for subgroup comparisons.
Results: MRD clearance (<0.01%) at the predefined analytic endpoint was achieved in 66.7% of patients. Clearance was more frequent in standard-risk than high-risk patients (85.71% vs. 40.00%; risk difference: 45.71%, 95% CI: 7.60–83.80; p = 0.032) and in CD20-negative compared to CD20-positive patients (86.67% vs. 52.38%; risk difference: 34.33%, 95% CI: 8.60–60.00; p = 0.040). No significant associations were found with initial blast count or steroid response. The 3- and 5-year Kaplan–Meier–adjusted OS and EFS were both 96.55% (95% CI: 77.95–99.51%). One non-relapse death due to infection was recorded.
Conclusion: This study demonstrates favorable survival outcomes among ALL patients at Evercare Hospital pediatric in Bangladesh who completed standardized therapy. MRD clearance was significantly associated with risk classification and CD20 expression, underscoring its utility in risk stratification. Larger, prospective multicenter studies are required to validate these findings and guide treatment strategies in resource-limited settings
Type of Study: Research |
Subject:
Hematology
Received: 2025/10/8 | Accepted: 2026/05/19 | Published: 2026/06/17
Received: 2025/10/8 | Accepted: 2026/05/19 | Published: 2026/06/17
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