Childhood acute lymphoblastic leukemia in the Middle East and neighboring countries

A prospective multi-institutional international collaborative study (CALLME1) by the Middle East Childhood Cancer Alliance (MECCA)

Naima A. Al-Mulla, Prem Chandra, Mohammed Khattab, Faris Madanat, Parvaneh Vossough, Eyad Torfa, Zakiya Al-Lamki, Gamal Zain, Samar Muwakkit, Salah Mahmoud, Abdulrahman Al-Jassmi, Murat Tuncer, Hussein Al-Mukharraq, Sihem Barsaoui, Robert J. Arceci, Scott C. Howard, Andreas E. Kulozik, Yaddanapudi Ravindranath, Gregory H. Reaman, Mohammad Farranoush & 1 others Abdullah A. Alnasser

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Little is known about childhood ALL in the Middle East. This study was undertaken by MECCA as initial efforts in collaborative data collection to provide clinical and demographic information on children with ALL in the Middle East. Procedure: Clinical and laboratory data for patients with ALL between January 2008 and April 2012 were prospectively collected from institutions in 14 Middle East countries and entered into a custom-built-database during induction phase. All laboratory studies including cytogenetics were done at local institutions. Results: The 1,171 voluntarily enrolled patients had a mean age of 6.1±3.9 years and 59.2% were boys. T-ALL represented 14.8% and 84.2% had B-precursor ALL. At diagnosis, 5.6% had CNS disease. The distribution of common genetic abnormalities reflected a similar percentage of hyperdiploidy (25.6%), but a lower percentage of ETV6-RUNX1 translocation (14.7%) compared to large series reported from Western populations. By clinical criteria, 47.1% were low/standard risk, 16.9% were intermediate risk, and 36% were high risk. Most patients received all their care at the same unit (96.9%). Patients had excellent induction response to chemotherapy with an overall complete remission rate of 96%. Induction toxicities were acceptable. Conclusions: This first collaborative study has established a process for prospective data collection and future multinational collaborative research in the Middle East. Despite the limitations of an incomplete population-based study, it provides the first comprehensive baseline data on clinical characteristics, laboratory evaluation, induction outcome, and toxicity. Further work is planned to uncover possible biologic differences of ALL in the region and to improve diagnosis and management. Pediatr Blood Cancer 2014; 61:1403-1410.

Original languageEnglish
Pages (from-to)1403-1410
Number of pages8
JournalPediatric Blood and Cancer
Volume61
Issue number8
DOIs
Publication statusPublished - 2014

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Middle East
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Neoplasms
Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
Polyploidy
Central Nervous System Diseases
Cytogenetics
Population
Demography
Databases
Drug Therapy
Research

Keywords

  • Induction
  • Leukemia
  • MECCA
  • Pediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Childhood acute lymphoblastic leukemia in the Middle East and neighboring countries : A prospective multi-institutional international collaborative study (CALLME1) by the Middle East Childhood Cancer Alliance (MECCA). / Al-Mulla, Naima A.; Chandra, Prem; Khattab, Mohammed; Madanat, Faris; Vossough, Parvaneh; Torfa, Eyad; Al-Lamki, Zakiya; Zain, Gamal; Muwakkit, Samar; Mahmoud, Salah; Al-Jassmi, Abdulrahman; Tuncer, Murat; Al-Mukharraq, Hussein; Barsaoui, Sihem; Arceci, Robert J.; Howard, Scott C.; Kulozik, Andreas E.; Ravindranath, Yaddanapudi; Reaman, Gregory H.; Farranoush, Mohammad; Alnasser, Abdullah A.

In: Pediatric Blood and Cancer, Vol. 61, No. 8, 2014, p. 1403-1410.

Research output: Contribution to journalArticle

Al-Mulla, NA, Chandra, P, Khattab, M, Madanat, F, Vossough, P, Torfa, E, Al-Lamki, Z, Zain, G, Muwakkit, S, Mahmoud, S, Al-Jassmi, A, Tuncer, M, Al-Mukharraq, H, Barsaoui, S, Arceci, RJ, Howard, SC, Kulozik, AE, Ravindranath, Y, Reaman, GH, Farranoush, M & Alnasser, AA 2014, 'Childhood acute lymphoblastic leukemia in the Middle East and neighboring countries: A prospective multi-institutional international collaborative study (CALLME1) by the Middle East Childhood Cancer Alliance (MECCA)', Pediatric Blood and Cancer, vol. 61, no. 8, pp. 1403-1410. https://doi.org/10.1002/pbc.25031
Al-Mulla, Naima A. ; Chandra, Prem ; Khattab, Mohammed ; Madanat, Faris ; Vossough, Parvaneh ; Torfa, Eyad ; Al-Lamki, Zakiya ; Zain, Gamal ; Muwakkit, Samar ; Mahmoud, Salah ; Al-Jassmi, Abdulrahman ; Tuncer, Murat ; Al-Mukharraq, Hussein ; Barsaoui, Sihem ; Arceci, Robert J. ; Howard, Scott C. ; Kulozik, Andreas E. ; Ravindranath, Yaddanapudi ; Reaman, Gregory H. ; Farranoush, Mohammad ; Alnasser, Abdullah A. / Childhood acute lymphoblastic leukemia in the Middle East and neighboring countries : A prospective multi-institutional international collaborative study (CALLME1) by the Middle East Childhood Cancer Alliance (MECCA). In: Pediatric Blood and Cancer. 2014 ; Vol. 61, No. 8. pp. 1403-1410.
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abstract = "Background: Little is known about childhood ALL in the Middle East. This study was undertaken by MECCA as initial efforts in collaborative data collection to provide clinical and demographic information on children with ALL in the Middle East. Procedure: Clinical and laboratory data for patients with ALL between January 2008 and April 2012 were prospectively collected from institutions in 14 Middle East countries and entered into a custom-built-database during induction phase. All laboratory studies including cytogenetics were done at local institutions. Results: The 1,171 voluntarily enrolled patients had a mean age of 6.1±3.9 years and 59.2{\%} were boys. T-ALL represented 14.8{\%} and 84.2{\%} had B-precursor ALL. At diagnosis, 5.6{\%} had CNS disease. The distribution of common genetic abnormalities reflected a similar percentage of hyperdiploidy (25.6{\%}), but a lower percentage of ETV6-RUNX1 translocation (14.7{\%}) compared to large series reported from Western populations. By clinical criteria, 47.1{\%} were low/standard risk, 16.9{\%} were intermediate risk, and 36{\%} were high risk. Most patients received all their care at the same unit (96.9{\%}). Patients had excellent induction response to chemotherapy with an overall complete remission rate of 96{\%}. Induction toxicities were acceptable. Conclusions: This first collaborative study has established a process for prospective data collection and future multinational collaborative research in the Middle East. Despite the limitations of an incomplete population-based study, it provides the first comprehensive baseline data on clinical characteristics, laboratory evaluation, induction outcome, and toxicity. Further work is planned to uncover possible biologic differences of ALL in the region and to improve diagnosis and management. Pediatr Blood Cancer 2014; 61:1403-1410.",
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TY - JOUR

T1 - Childhood acute lymphoblastic leukemia in the Middle East and neighboring countries

T2 - A prospective multi-institutional international collaborative study (CALLME1) by the Middle East Childhood Cancer Alliance (MECCA)

AU - Al-Mulla, Naima A.

AU - Chandra, Prem

AU - Khattab, Mohammed

AU - Madanat, Faris

AU - Vossough, Parvaneh

AU - Torfa, Eyad

AU - Al-Lamki, Zakiya

AU - Zain, Gamal

AU - Muwakkit, Samar

AU - Mahmoud, Salah

AU - Al-Jassmi, Abdulrahman

AU - Tuncer, Murat

AU - Al-Mukharraq, Hussein

AU - Barsaoui, Sihem

AU - Arceci, Robert J.

AU - Howard, Scott C.

AU - Kulozik, Andreas E.

AU - Ravindranath, Yaddanapudi

AU - Reaman, Gregory H.

AU - Farranoush, Mohammad

AU - Alnasser, Abdullah A.

PY - 2014

Y1 - 2014

N2 - Background: Little is known about childhood ALL in the Middle East. This study was undertaken by MECCA as initial efforts in collaborative data collection to provide clinical and demographic information on children with ALL in the Middle East. Procedure: Clinical and laboratory data for patients with ALL between January 2008 and April 2012 were prospectively collected from institutions in 14 Middle East countries and entered into a custom-built-database during induction phase. All laboratory studies including cytogenetics were done at local institutions. Results: The 1,171 voluntarily enrolled patients had a mean age of 6.1±3.9 years and 59.2% were boys. T-ALL represented 14.8% and 84.2% had B-precursor ALL. At diagnosis, 5.6% had CNS disease. The distribution of common genetic abnormalities reflected a similar percentage of hyperdiploidy (25.6%), but a lower percentage of ETV6-RUNX1 translocation (14.7%) compared to large series reported from Western populations. By clinical criteria, 47.1% were low/standard risk, 16.9% were intermediate risk, and 36% were high risk. Most patients received all their care at the same unit (96.9%). Patients had excellent induction response to chemotherapy with an overall complete remission rate of 96%. Induction toxicities were acceptable. Conclusions: This first collaborative study has established a process for prospective data collection and future multinational collaborative research in the Middle East. Despite the limitations of an incomplete population-based study, it provides the first comprehensive baseline data on clinical characteristics, laboratory evaluation, induction outcome, and toxicity. Further work is planned to uncover possible biologic differences of ALL in the region and to improve diagnosis and management. Pediatr Blood Cancer 2014; 61:1403-1410.

AB - Background: Little is known about childhood ALL in the Middle East. This study was undertaken by MECCA as initial efforts in collaborative data collection to provide clinical and demographic information on children with ALL in the Middle East. Procedure: Clinical and laboratory data for patients with ALL between January 2008 and April 2012 were prospectively collected from institutions in 14 Middle East countries and entered into a custom-built-database during induction phase. All laboratory studies including cytogenetics were done at local institutions. Results: The 1,171 voluntarily enrolled patients had a mean age of 6.1±3.9 years and 59.2% were boys. T-ALL represented 14.8% and 84.2% had B-precursor ALL. At diagnosis, 5.6% had CNS disease. The distribution of common genetic abnormalities reflected a similar percentage of hyperdiploidy (25.6%), but a lower percentage of ETV6-RUNX1 translocation (14.7%) compared to large series reported from Western populations. By clinical criteria, 47.1% were low/standard risk, 16.9% were intermediate risk, and 36% were high risk. Most patients received all their care at the same unit (96.9%). Patients had excellent induction response to chemotherapy with an overall complete remission rate of 96%. Induction toxicities were acceptable. Conclusions: This first collaborative study has established a process for prospective data collection and future multinational collaborative research in the Middle East. Despite the limitations of an incomplete population-based study, it provides the first comprehensive baseline data on clinical characteristics, laboratory evaluation, induction outcome, and toxicity. Further work is planned to uncover possible biologic differences of ALL in the region and to improve diagnosis and management. Pediatr Blood Cancer 2014; 61:1403-1410.

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KW - Leukemia

KW - MECCA

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