{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:52:23Z","timestamp":1753883543879,"version":"3.41.2"},"reference-count":14,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Global Oncology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> Data on survival outcomes in patients with acute lymphoblastic leukemia (ALL) originating from Nepal are limited. We aim to present the real-world data on treatment outcomes of patients with de novo ALL treated with pediatric ALL-Berlin-Frankfurt-Muenster (BFM)-95 protocol in Nepal. <\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS AND METHODS<\/jats:title><jats:p> We used the medical records of 103 consecutive patients with ALL treated in our center from 2013 to 2016 to evaluate the overall survival (OS) and relapse-free survival (RFS) and analyzed the effects of clinicopathologic factors on survival outcomes in patients with ALL. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> The 3-year OS and RFS in the entire cohort was 89.4% (95% CI, 82.1 to 96.7) and 87.3% (95% CI, 79.8 to 94.7), with a mean OS and RFS of 79.4 months (95% CI, 74.2 to 84.5) and 76.6 months (95% CI, 70.8 to 82.4), respectively. Patients with prednisone good response (PGR) showed better mean OS and RFS, whereas complete marrow response on day 33 was associated with better mean OS alone. Patients with Philadelphia (Ph)-positive ALL showed worse mean RFS compared to those with Ph-negative status. On multivariate analysis, PGR (hazard ratio [HR], 0.11; 95% CI, 0.03 to 0.49; P = .004) and sagittal vein thrombosis (SVT; HR, 5.95; 95% CI, 1.30 to 27.18; P = .02) were the only independent predictors of OS and RFS, respectively. Adverse events on BFM-95 protocol included SVT (4.9%), peripheral neuropathy (7.8%), myopathy (20.4%), hyperglycemia (24.3%), intestinal obstruction (7.8%), avascular necrosis of femur (6.8%), and mucositis (46%). <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> BFM-95 protocol appears to be a safe and effective strategy in adolescent and young adults and adult Nepalese population with ALL with a low toxicity profile. <\/jats:p><\/jats:sec>","DOI":"10.1200\/go.22.00408","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T19:59:39Z","timestamp":1689019179000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["Outcome of ALL With ALL-BFM-95 Protocol in Nepal"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5896-0379","authenticated-orcid":false,"given":"Bishesh","family":"Sharma Poudyal","sequence":"first","affiliation":[{"name":"Clinical Hematology and Bone Marrow Transplant Unit, Civil Service Hospital, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bishal","family":"Paudel","sequence":"additional","affiliation":[{"name":"Clinical Hematology and Bone Marrow Transplant Unit, Civil Service Hospital, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sampurna","family":"Tuladhar","sequence":"additional","affiliation":[{"name":"Department of Pathology, Civil Service Hospital, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Neupane","sequence":"additional","affiliation":[{"name":"Department of Pathology, Civil Service Hospital, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kushal","family":"Bhattarai","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Karnali Academy of Health Sciences, Jumla, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8251-5846","authenticated-orcid":false,"given":"Utsav","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Rochester General Hospital, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24420"},{"key":"b2","first-page":"1399","volume":"63","author":"Mushtaq N","year":"2013","journal-title":"J Pak Med Assoc"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31820e7361"},{"key":"b4","doi-asserted-by":"publisher","DOI":"10.3126\/jnps.v34i1.9056"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-09-112920"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2017.5305"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-02-778530"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.8192"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2011.09020.x"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2019.5868"},{"key":"b11","first-page":"2730","volume":"92","author":"Schrappe M","year":"1998","journal-title":"Blood"},{"key":"b12","first-page":"7858","volume":"22","author":"Gao J","year":"2018","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"b13","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24130"},{"key":"b14","doi-asserted-by":"publisher","DOI":"10.5414\/CPP46584"}],"container-title":["JCO Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/GO.22.00408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T19:59:44Z","timestamp":1689019184000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/GO.22.00408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1200\/GO.22.00408"],"URL":"https:\/\/doi.org\/10.1200\/go.22.00408","relation":{},"ISSN":["2687-8941"],"issn-type":[{"type":"electronic","value":"2687-8941"}],"subject":[],"published":{"date-parts":[[2023,6]]},"assertion":[{"value":"2022-12-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-13","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2200408"}}