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Outcomes of Pediatric Precursor B Cell Acute Lymphoblastic Leukemia: A Tertiary Care Cancer Center Experience from a Lower-Middle-Income Country Cover

Outcomes of Pediatric Precursor B Cell Acute Lymphoblastic Leukemia: A Tertiary Care Cancer Center Experience from a Lower-Middle-Income Country

Open Access
|Sep 2026

Figures & Tables

Table 1.

Biodemographic Characteristics of Study Population.

CharacteristicNumber (Percentage %)
Age
Age, median (years)3
Age, mean (years)3.3
Age range (years)1–7 (IQR: 3–4)
Gender
• Male268 (61.5%)
• Female168 (38.5%)
Follow up
Follow-up, median (months)46 (IQR: 26–64)
Total Patients436
Risk Group
Standard-risk420 (96.3%)
High-risk16 (3.7%)
CNS involvement2 (<1%)
CNS 21
CNS 31
Testicular Involvement5 (1.1%)
Treatment Regimen
Standard-risk420 (96.3%) 3 Drug Induction
High-risk16 (3.7%) (4 Drug Induction)
Table 2.

Details of FISH/Karyotype.

FISH / KaryotypeNumber of Patients
Performed in all patients436
No result/not performed5
TEL-AML/ETV6/RUNX1 translocation72
MLL Gene rearrangement2
BCR ABL translocation6
Hyperploidy11
Hypodiploidy or Haploidy0
Hypotriploidy1
Translocation (1:19)3
Normal Karyotype336
Table 3.

Details about Treatment Response.

Remission StatusNumber (Percentage %)
Total patients436
• Post induction Bone marrow examination (BME) performed389 (89.2%)
• Post induction number of patients who did not have BME47 (10.8%)
Standard risk Patient who had BME (n = 373)
• Complete remission post induction (Minimal residual disease MRD on FCM) ≤0.01305 (81.8%)
• MRD-positive end of induction (≥0.01 on FCM)65 (17.4%)
• MRD-positive end of induction (≥5% on FCM)3 (0.8%)
• MRD-positive end of consolidation (≥0.01 on FCM)13 (3.5%)
High risk (n = 16)
• Complete remission12 (75.0%)
• MRD-positive at end of induction4 (25%)
• MRD Positive end of consolidation2 (12.5%)
Table 4.

Relapse Details of the Included Patients.

CharacteristicNumber of patients (%)
Total Patients in complete remission374
Total number of relapses56 (14.9%) *
Type of Relapse based on TimingTotal 56
Very early relapse13 (23.2%)
Early relapse23 (41.1%)
Late relapse20 (35.7%)
Type of Relapse based on involved siteTotal 56
Isolated Bone marrow relapse30 (53.6%)
Isolated CNS relapse10 (17.8%)
Combined Relapse16 (28.6)

* Out of total number of patients who achieved remission.

Table 5.

Mortality related Statistics of the Study Population.

CharacteristicNumber of patients (%)
Total Patients436
Overall mortality114 (26.1%)
Induction mortality51 (11.7%)*
Causes of death
Sepsis74 (59.7%)
Relapse36 (29%)
Refractory disease3 (2.4%)
Other causes11 (8.9%)

* Out of 436 patients.

Figure 1.

Five-year overall survival (OS) of precursor B cell acute lymphoblastic lymphoma patients cohort treated at our centre.

Figure 2.

Five-year event free survival (EFS) of precursor B cell acute lymphoblastic lymphoma patients cohort treated at our centre.

Language: English
Page range: 129 - 135
Published on: Sep 10, 2026
Published by: Shakuat Khanum Memorial Cancer Hospital and Research Centre
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2026 Naeem Akram Butt, Najma Shaheen, Irfana Ishaq Sindhu, Amina Anwar, Saba Sattar, Hafiz Muhammad Mubashir Waheed, Hiba Asif, Ammarah Tahir, Aqeela Rashid, published by Shakuat Khanum Memorial Cancer Hospital and Research Centre
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.