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INITIAL COMMENTS ON PROGNOSTIC FACTORS IN 35 CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA AT NATIONAL INSTITUTE OF PEDIATRIC OF HANOI - VIETNAM

Tran Thi Hong Ha, Vo Thanh Huong, Nguyen Cong Khanh, Phan Thi Phi Phi, Pham Quang Vinh

National Institute of Pediatric of Hanoi, Vietnam

Objectives: Initial study on prognotic factors in children with acute lymphoblastic leukenia (ALL) in Vietnam.

Materials and methods: 35 children suffered from ALL, 16 children were treated, 9 children were achieved complete remission and 7 another were on the continuing treatment. All patients were classified by morphology with FAB criteria and by immunology with immunofluorescence indirect assay with anti-CD3, anti-CD4, anti-CD8, anti-CD19. Analyse chromosomes of bone marrow cells by cells culture and chromosomal banding technique.

Results: Age of onset, sex, morphology FAB, labolatory findings: Age: 2-10 years old 74.2%-<2 years old 2.9% and >10 years old 22.9%. Sex: Male 68.6%, female: 31.4%, WBC: <50.10⁹/1: 62.8%-��100.10⁹/1:8 cases (22.9%) all are male.

Morphology FAB: L₁: 91.4%-L₂: 8.6%. Hemoglobin level: <100g/l: 94.3%-��100g/l: 5.7%. Platelet count: <50.10⁹/l: 71.4%->100.10⁹/l:5.7%

-Immunophenotype: Null-cell ALL 80.6% of cases, mainly in group 2-10 years old (80%) and WBC<50.10⁹/l (36%). All cases with T-cell All (9.7%) are male, >10 years old and WBC >100.10⁹/l. B-cell ALL (9.7%) distributed more scatter among the age, sex, WBC morphology group.

Cytogenetic: At diagnosis: Normal 33.3%. Hyperploidy (47) 13.3%. Hypoploidy (44,45) 26.7%. Pseudodiploidy 26.7%. In this number, some chromosomal abnormalities associated with poor prognosis: 1 case philadelphia positive, 1 case had both 9p and 14q⁺.

In complete remission, 8 cases were analysed chromosomes, the chromosomal abnormalities were disappeared in all cases.

Conclusion: Age, sex, morphology FAB and labolatory findings: Rate % patients in favorable prognostic group were high, excluding sex and platelet count. Patients with T-cell ALL tend to be higher initial leukocyte count, male and older age. At diagnosis, chromosomal abnormalities were found 2/3 of cases, some in which associated with poor prognosis (Phl-positive, 9q^-, 14q⁺). In complete remission, the chromosomal abnormalities were disappeared in all cases analysed chromosomes.