Early Steroid Response is the Prognostic Factor of Remission in Children with Acute Lymphoblastic Leukemia during Induction Phase Chemotherapy

Introduction: Acute Lymphoblastic Leukemia (ALL) as the most common type of cancer in children has a high cure rate with chemotherapy treatment. The incidence of induction phase remission was found to be directly proportional to the overall success of ALL treatment. The initial steroid response to the induction phase of chemotherapy is thought to have a prognostic role in ALL treatment. Objective: To determine the initial steroid response as a prognostic remission factor in ALL children during induction phase chemotherapy treatment using the 2013 ALL National Child Protocol. Materials and methods: An observational analytic study with a prospective cohort design at Sanglah Hospital, Denpasar, since May 2017 until the sample study has reached. The study was conducted data from medical records. Children with ALL will enter the stage of the initial steroid induction phase for the first 7 days. On the 8th day, a blood smears examination done to evaluate the steroid response. Children grouped as positive blast and negative blast. They prospectively observe during induction phase for the remission. Results: Of the 39 children with LLA, 23 subjects had good responders and 16 subjects were poor responders. From both, 31 subjects were remission and 8 subjects were not remission. Bivariate analysis showed that the initial steroid response was associated with the induction phase remission (RR=1.46 (95% CI 0.98-2.18), p=0.03). Conclusion: This study proves that there is a relationship between the initial steroid response and the occurrence of the induction phase remission. Keywords: Acute lymphoblastic leukemia, Initial steroid response, Remission