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The Outcome Of Indonesian Protocol Chemotherapy Acute Lymphoblastic Leukemia 2018 Induction Phase at Dr. Soetomo Hospital

Background: The prognosis of pediatric acute lymphoblastic leukemia (ALL) has improved in the last 50 years. In Indonesia, national protocol of ALL chemotherapy is divided into 2 risk stratification, standard risk and high risk. The outcome after the induction phase of chemotherapy has an important role and has prognostic factor for the success of ALL chemotherapy. Objective: To determine the outcome of induction phase chemotherapy using the pediatric ALL 2018 national protocol at Dr. Soetomo Hospital Methods This prospective study was conducted from November 2020 to May 2021. Consecutive non-random sampling was done to children aged 1-18 years, recently diagnosed with ALL, and met the inclusion-exclusion criteria. Risk stratification was made based on age, initial leukocyte count, presence of a mediastinal mass, presence of CNS leukemia, and immunophenotyping. Evaluation of bone marrow aspiration was done after the sample had completed the induction phase of ALL chemotherapy according to the 2018 ALL national protocol stratification. Results: Twenty-one children recently diagnosed with ALL and underwent chemotherapy. Fourteen children underwent standard risk national protocol of ALL chemotherapy, and 7 remaining with high risk. Fifteen children completed the induction phase of chemotherapy, 6 remaining children died before completing. All patient underwent standard risk chemotherapy can complete induction phase. All patients who completed the induction phase showed remission on bone marrow aspiration evaluation. Conclusion: Patients who underwent standard risk of Indonesian protocol chemotherapy ALL 2018 have better outcome than high risk.