Volume 24, Issue 102, March - April, 2020

Assessment of the short term outcomes of different chemotherapy protocols in adult acute lymphoblastic leukemia patients at Baghdad Teaching Hospital

Rana Ali Hussein¹, Bassam Francis Matti², Abeer Abdulhadi Rashid³, Hassan Mohammed Abbas⁴, Laith Ghadhanfer Shareef^5♦

¹Clinical pharmacy specialist, Intensive Care Unit, Baghdad Teaching Hospital, Medical City, Iraq (B.Pharm, FIBMS CP). Email: phrana2010@gmail.com
²Consultant Hematologist, Baghdad Teaching Hospital, Medical City, Iraq. (C.A.B.M./F.I.C.M.S. Hematology); Email: bassam_francis@yahoo.com
³Department of Clinical Pharmacy, College of Pharmacy, Mustansiriyah University, Iraq; Email: abeeralrashid@uomustansiriyah.edu.iq
⁴Ph.D. Clinical Pharmacy, Medical City, Iraq, Email: drhaltemimi@dr.com
⁵Former Resident at Iraqi Board of Clinical Pharmacy, Medical City, Iraq, Email: laithalkunani@yahoo.com

^♦Corresponding author
Former Resident at Iraqi Board of Clinical Pharmacy, Medical City, Iraq, Email: laithalkunani@yahoo.com

ABSTRACT

Background: Acute lymphoblastic leukemia (ALL) is a neoplastic disease of immature lymphocytes or lymphocyte progenitor cells for either the B or T cell lineage, multiple induction ways have been developed for adult patients with acute lymphoblastic leukemia (ALL). Though, only a few prospective randomized trials have directly paralleled these regimens with their outcome results. Aims of the study: Assessment of the response rate of adult patients treated with UKALL protocols and Hyper-CVAD protocol in acute lymphoblastic leukemia patients, and the impact of different prognostic factors on outcome. Patients and methods: A prospective cohort study conducted in the hematology unit of Baghdad Teaching Hospital on 47 adult ALL patients treated with either UKALL (United Kingdom Acute Lymphoblastic Leukemia include UKAL12, UKALL11"B, C") or hyper-CVAD (hyper fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone) protocols between March 2016 and May 2017 with mean followup of 6.16 months. Results: This study included 47 adult patients with the mean age of (23.9 years) with the male: female ratio of (2.1:1). Complete remission after induction therapy was achieved in 66.7% and 79.3% of the patients by hyper-CVAD and UKALL, respectively. The mortality rate was 16.0% and 6.89% for hyper-CVAD and UKALL respectively, while the eight months OS and PFS was 84% and 65% for hyper-CVAD and 78% and 62% for UKALLs. Conclusion: Although our study was short duration with small sample size, it was able to show the efficacy of both hyper-CVAD and UKALLs protocols in the treatment of Philadelphia negative ALL, with good initial complete remission mainly after induction phase. There was no difference in the response rate between both studied protocols according to different age groups (above or below 25 years old).

Keywords: Hematology, Chemotherapy, ALL, Hyper-CVAD, UKALLs

Medical Science, 2020, 24(102), 435-450

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