# A survival analysis of paediatric acute lymphoblastic leukaemia patients at the Moroccan University Hospital Centre of Rabat

## TL;DR

This study examines survival rates and factors affecting outcomes in children with acute lymphoblastic leukemia in Morocco, showing promising results but identifying areas for improvement.

## Contribution

The study provides survival data and identifies prognostic factors specific to Moroccan pediatric ALL patients under a standardized treatment protocol.

## Key findings

- 56.2% of patients achieved complete remission after first-line treatment.
- The 5-year overall survival rate was 63%, exceeding the WHO target of 60%.
- Age ≥10 years, high white blood cell count, and elevated lactate dehydrogenase levels were significant negative prognostic factors.

## Abstract

Acute lymphoblastic leukaemia (ALL) is the most common childhood leukaemia and a significant cause of paediatric mortality worldwide. Morocco, as part of the World Health Organisation (WHO) Global Initiative for Childhood Cancer, aims to achieve a 60% survival rate for paediatric cancers by 2030.

This study evaluates survival rates and prognostic factors for paediatric ALL patients treated according to the MARALL 2006 protocol at the University Hospital Centre Ibn Sina in Rabat, Morocco.

A retrospective cohort study analysed data from 512 children diagnosed with ALL between June 2006 and December 2017. Sociodemographic, clinical and therapeutic data were collected. Kaplan–Meier and Cox regression analyses identified survival rates and prognostic factors.

Among the patients, 56.2% achieved complete remission after first-line treatment and 20.9% experienced relapse. The 1-, 3- and 5-year overall survival rates were 83%, 67% and 63%, respectively. Significant prognostic factors included age ≥10 years, white blood cell count >50,000/mm3 and elevated lactate dehydrogenase levels. Standard risk classification and B-cell immunophenotype were associated with better survival outcomes.

This study highlights encouraging survival rates for paediatric ALL patients in Morocco, exceeding the WHO target of 60%. However, achieving the national goal of 80% survival requires further improvements in early diagnosis, treatment access and adoption of advanced therapies.