الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Acute lymphoblastic leukemia is largely a juvenile illness, with 75 percent of cases diagnosed in kids under the age of ten years. Despite the fact that ALL is uncommon in adults, it does become more common around the age of 40. The B– cell lineage accounts for 85% of cases and has an equal sex incidence; T–cell ALL accounts for 15% of cases and has a male preponderance.
Because ALL has a broad clinical appearance, individuals may have ”B symptoms” such as infection, easy bruising/bleeding, also exhaustion.
The existence of 20% or more lymphoblast in the bone marrow is needed for the diagnosis of ALL. Flow cytometer, morphological investigations, immune phenotyping, and cytogenetic tests are all necessary for further evaluation.
When lymphoblast are initially implicated, the major objective of induction treatment is to completely eradicate them from the blood, bone marrow, CNS, and other extra medullary locations. Complete remission (CR) is presently known as less than 5% lymphoblast in the bone marrow with general hematological recovery.
Although there is no widely accepted induction strategy, most adult treatment regimens follow a similar pattern in terms of medication dose and timing. CALGB is one of the regimens.
An extensive, multi agent induction phase, 20–30 weeks of asparaginases during post-remissions consolidation, and numerous vincristine/corticosteroids pulses in the continuation phase formed the therapeutic backbone of the DFCI Consortium studies.
According to recent studies, CR rates for DFCI under 35 years old are 98 percent, while 81 percent for those over 35 years old are 81 percent.
The majority of induction fatalities are caused by severe bacterial sepsis, although fungal infection is also a serious concern. Oral mucositis was the most often diagnosed site of infection in an Egyptian research that included ALL patients undergoing induction chemotherapy, followed by skin, GIT, and lower respiratory tract infections.
The purpose of this study is to evaluate the outcomes of the CALGB 8811 and DFCI 85-01 protocols for adult ALL patients in terms of CR rate and MRD after induction, as well as the rate of bacterial and fungal infection throughout the induction cycle.
This research involved 30 adults with ALL. 15 patients were on the CALGB 8811 induction cycle and 15 patients were on the DFCI 85-01 induction cycle, with each patient having a BMA with MRD evaluation on the 28th day of the cycle. They were tested for blood CRP, procalcitonin, and galactomannan ag assays during neutropenic fever during induction chemotherapy. Blood cultures were taken for all patients, sputum cultures for patients who could expectorate a suitable sample for culture, urine cultures for patients with pyuria and dysuria, and pus cultures for patients who had abscesses as a source of infection.
The DFCI 85-01 group (93.3%) has a higher percentage of patients who obtained full remission than the CALGB 8811 group (53.3%), which is statistically significant. (0.035; p =0.035) During both induction cycles, the rates of bacterial and fungal infection were comparable.