الفهرس 
LeukemiaOnly 14 pages are availabe for public view
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Abstract
This study was undertaken to assess the epidemiological, clinical and para-clinical characteristics of childhood cancer attended in Pediatric Department, Hematology Oncology Unit, Menoufia University Hospital during last fifteen years, aiming to:
1. Explore the epidemiologic data of pediatric patient with childhood cancer.
2. Estimation of different types of survival {disease free survival (DFS), event free survival (EFS), relapse free survival (RFS), overall survival (OS)} in childhood cancer and their correlation with different prognostic factors.
3. Identify the relapse risk group parameters based on cytogenetic abnormalities and early response to therapy.
4. Demonstrate the most common causes of deaths among pediatric patients with childhood cancer.
In this study, we found that cancer in children becomes more prevalent. It is one of the most leading causes of death among children. Leukemia and lymphoma represent the most frequent pediatric malignancies followed by tumors of the CNS are the most common solid tumor. Also, in this study we found that the age group between 1-9 years was the most affected. Male patients were more predominant than female. Fever, hepatomegaly, lymphadenopathy, splenomegaly and pallor were the most common clinical presentation. CNS involvement was seen only in 1.0 % of patients in this study.
Also, in this study we found that the majority of the patients had WBC less than 50,000/mm³. By immunophenotyping, precursor-B ALL constituted the majority of ALL patients.
Remission rate was more than 90%. The relapse was 9%. The most common site of relapse was medullary. The most common causes of mortality from ALL patients were infections followed by hemorrhage and time of death was mainly during induction phase of treatment.
Distribution of the ALL cases according to the risk stratification of tumor showed that (65.8%) of patients were stratified as standard risk and (34.2%) were low risk. This classification depends on clinical prognostic factors (age, white cell count at time of diagnosis, CNS involvement, early response to induction therapy, biological and genetic feature and minimal residual disease).
Various clinical and laboratory features present at the time of initial diagnosis can predict the likelihood that a patient will remain in remission or not. Unfavorable prognostic factors in ALL include age: under 1 and over 10 years, gender: males sex, WBCS more than 50,000/mm³ at presentation, mediastinal LN (T-cell), CNS involvement, testicular involvement, failure to achieve remission at the end of induction and immunophenotype and cytogenetic characteristics.
With the help rapid development in the fields of cytogenetic and immunophenotyping, CNS prophylaxis and multiple chemotherapies in the treatment of ALL, most patients can be cured and serious improvements in the overall survival (OS) and relapse -free survival (RFS) are achieved. Childhood cancer survivors are at higher risk for chronic disease.