JPSB logo
Association of Paediatric Surgeons of Bangladesh
Journal of Paediatric Surgeons of Bangladesh
Original Articles · Vol. 6 No. 1 (2015)

Effectiveness of Dexamethasone compared with Prednisolone in Induction Therapy of Childhood Acute Lymphoblastic Leukemia

Cover
JPSB
Journal of
Paediatric Surgeons of Bangladesh
Published : January 2015
CONTENTSVolume 06Number 1January 2015
Editorial
Residency Program A new era in postgraduate medical education in Bangladesh
Md Tosaddeque Hossain Siddiqui
01
Review Articles
Constipation in Children
Kaniz Hasina
20
Original Articles
Effectiveness of Dexamethasone compared with Prednisolone in Induction Therapy of Childhood Acute Lymphoblastic Leukemia
Tofazzal Hossain, MA Mannan, Shamsoon Nahar, AKM Amirul Morshed, Shahnoor Islam, Laila Helaly
03
Gender Specific Psychological Distress in Cancer Patients with Underage Children
Jamila Akter, Manzurul Haque Khan, Jaglul Gaffer Khan
10
Diagnostic Role of Pediatric Appendicitis Score (PAS) in Appendicitis of Children
Susankar Kumar Mondal, AKM Zahid Hossain, Mizanur Rahman, Gazi Zahirul Hasan, Kaniz Hasina, Md Nuruzzaman
16
Case Reports
Gastric Bezoar - A Rare Presentation in Infant
MTH Siddiqui, Mohammad Mahabubul Alam, AM Shahinur, AKM Zahid Hossain, Gazi Zahirul Hasan
24
Combined MACE & Mitrofanoff Procedure for Total Neurogenic Feco-urinary Incontinence A Case Report
KM Didarul Islam, Md Ruhul Amin, Abu Saleh Md Oliullah, AKM Khairul Basher, Amitava Biswas, Nazrul Islam
28
The Official Journal of the
ASSOCIATION OF PAEDIATRIC SURGEONS OF BANGLADESH (APSB)
View Contents

Authors

  • Tofazzal HossainMedical Officer, Upazilla Health Complex, Sonaimuri, Noakhali
  • MA MannanEx.Professor and Pro-vice chancellor, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka
  • Shamsoon NaharJr. Consultant (Gynae and Obs.), Kaligonj Upazilla Health Complex, Gazipur, Dhaka
  • AKM Amirul MorshedAssociate Professor, Department of Pediatric Hematology and Oncology, Dhaka Medical College Hospital, Dhaka
  • Shahnoor IslamAssociate Professor, Department of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka
  • Laila HelalyRegistrar, Department of Pediatrics, Delta Medical College Hospital, Mirpur, Dhaka

Abstract

Background: Corticosteroids are an essential component of treatment for acute lymphoblastic leukemia (ALL). Prednisolone is the most commonly used steroid. There is increasing evidence that, even in equipotent dosage for glucocorticoid effect, dexamethasone has enhanced lymphoblast cytotoxicity and penetration of central nervous system compared with prednisolone. Objectives: To determine the effect of dexamethasone and prednisolone and to compare them in induction therapy of ALL in Children. Material & Methods: A total of 60 newly diagnosed cases of ALL confirmed by bone marrow study, children of either sex with age >1 year were included in this study. Variables studied were age, sex, presenting features, neutrophil count, blast cell count, platelet count, bone marrow status at diagnosis, on D15 & D29 of induction and side effects. Results: Mean age of the patients of group A was 6.28 years & that of group B was 7.2 years. Out of all patients of group A 19 (63.3%) were male and 11 (36.7%) were female. In group B 21 (70.0%) patients were male and rests 9 (30.3%) were female. No statistically significant difference was observed in both groups in terms of age, sex & presenting features. After induction significant difference was observed in liver & spleen size at day 7 and day 15. All patients of both groups had M3 marrow status at diagnosis. Overall, in group A 93.3% patients achieved M1 marrow status (fewer than 5% blasts) and 6.7% had M2 marrow status (5-25% blasts) at day 15 of induction. On the other side 66.7% patients of group B achieved M1 status and 33.3% M2 status at day 15. Statistically significant difference was observed between groups on day 15 in term of achieved marrow status (p<0.05). No statistically significant difference was observed between groups in term of infection in difference days of induction. On day 16 of induction maximum incidence of infection was observed in both groups. Conclusion: Dexamethasone may be an effective alternative option to prednisolone for the treatment of acute lymphoblastic leukemia in children.

Journal of Paediatric Surgeons of Bangladesh (2015) Vol. 6 (1): 3–9

Read full article (PDF)