Mortalidade e fatores associados ao óbito em crianças e adolescentes com leucemia linfoide aguda tratadas em um serviço de referência no Nordeste do Brasil

Abstract

Introduction: The outcomes of treatment of Acute Lymphoid Leukemia (ALL) in childhood in developing countries are inferior than those reported in devel- oped nations. Socioeconomic factors are potential predictors of mortality in this setting. The present study aims to assess the impact of socioeconomic characteristics on child- hood ALL mortality. Methods: This is a longitudinal, prospective cohort study. Pa- cients up to 19 years, diagnosed with immunophenotyping of peripheral blood or bone marrow between 2005 and October 2017. Results: We collected clinical, demographic and socioeconomic data at diagnosis and analyzed the impact of these variables on sur- vival, death on induction and relapse. We analyzed 149 patients. The mean age was 8,7 years with standard deviation of 5,2 years. Death throughout all phases of treatment was recorded in 66 cases (44.9%). Most (65.2%) were secondary to sepsis. Death occurred at induction in 36 cases (54.5%). Among the variables considered categorization as "hi- gh risk" for relapse, infectious event in induction of remission and relapses were associ- ated with deaths throughout the treatment. Conclusions: Realistic and accessible meas- ures for the prevention, diagnosis and immediate treatment of infectious episodes need to be tested and rapidly implemented in services with high morbidity due to infection among children and adolescents receiving treatment for ALL.