| dc.description.abstract | Background: Acute lymphoblastic leukemia (ALL) is the most common type of
childhood blood cancer in Indonesia, accounting for over 33% of all leukemia
cases. Despite ongoing updates to treatment protocols, the survival rate of
children with ALL in Indonesia remains low at around 30-60%, significantly
lower than in high-income countries where it approaches 90%. Several prognostic
factors—including age, sex, nutritional status, hemoglobin levels, initial white
blood cell (WBC) count, and early treatment response—are known to influence
survival. However, local studies examining survival and prognostic factors in
pediatric ALL remain limited, particularly at Adam Malik Hospital, a major
referral center in North Sumatra.
Objective: To determine the survival rate and prognostic factors in children with
ALL at Adam Malik Hospital.
Method: A retrospective cohort study was conducted using secondary data from
medical records and the leukemia patient registry at Adam Malik Hospital. The
study included pediatric ALL patients diagnosed between 2021 and 2022 and
treated according to the 2018 Indonesian ALL Protocol. Treatment outcomes were
assessed after a two-year follow-up period.
Result: The two-year survival rate of children with ALL at H. Adam Malik
Hospital was 47.2%. Log-rank analysis showed significant differences in survival
based on age (p = 0.016), hemoglobin level (p = 0.034), initial WBC count (p <
0.001), and risk stratification (p = 0.002). Multivariate analysis using Cox
proportional hazards regression revealed that only the initial WBC count had a
significant impact on mortality risk (p = 0.031; HR 2.046; 95% CI: 1.069–3.918).
Conclusion: The survival rate of pediatric ALL patients at H. Adam Malik
Hospital is relatively low. Initial white blood cell count at diagnosis significantly
influences outcomes in children with ALL. | en_US |
