Abstract

PROGNOSTIC VALUE OF PERIPHERAL BLOOD BLAST PERCENTAGE ON DAY 8 IN LONG TERM CURE IN PATIENTS WITH ALL

Neeti Vaghela, *Dr. I. S. Anand, Dr. Deepa H. Trivedi, Maulik Jani

ABSTRACT

Background and Objective: To correlate the peripheral blood blast percentage of day1 and day 8 in patients with acute lymphoblastic leukemia (ALL) post chemotherapy in long term cure outcome. Settings and Design: Single centric, retrospective study. Method and material: To determine the prognostic value of peripheral blood blast percentage, the database of 311 ALL patients who received BFM 90 and MCP 841 treatment protocol was screened from Vedanta Institute of medical sciences. Patients were classified into Prednisone good Responder (blast cells<1000) and prednisone poor responder (blast cells >1000) on the basis of their blast cell count on day 8 as well as Blast positive (appearance of blast cell any count on day 8) and Blast Negative (absence of blast cells on day 8) group. Patients with minimal 18 months of follow up were included in the study. (N=47) Results: Out of 47 patients, 31 were blast negative and 16 were blast positive. The blast negative patients had 76.1% chances while blast positive patients had 53.3% chances of 2 year event free survival. 42 patients were PGR and 5 patients were PPR. PGR had 71.42% chance of 2 year event free survival. As the sample size of PPR is small, no statistically significant conclusion can be derived. Conclusion: The result of our study shows that PGR have a good 2 yr EFS. Blast Negative patients fared much better than Blast Positive patients. Thus the present study though small in sample size, indicates that peripheral Blood Blast Percentage on day 8 have reliable prognostic value in long term cure in children and adults with Acute Lymphoblastic Leukemia.

Keywords: ALL, Prognosis, Blast cells, Prednisone Response.