Survival and Remission status:
Within all relapse sites and categories who received salvage
chemotherapy, eleven (36%) patients demonstrated Complete Remission
(CR) post-first salvage therapy, while twenty patients (64%) patients
went on to receive second-salvage therapy and a remission was achieved
in 11/20 patients, thus an overall remission rate of 71% was observed
in the study cohort. While, OS of all 31 patients at 3- years from
diagnosis was 62.3% with a median follow-up of 3.4 years (range: 0.9 to
13.2 years), while of those patients who atained CR post first-salvage
therapy (n=11) an overall survival at 3-years of 79.5% was observed
with a statistically significant (p- value <0.05) difference
when compared to patients who did not achieve remission post
first-salvage therapy (3-year OS: 46.4%). Similarly, a statistically
significant (p- value <0.05) difference in OS at 3-years was
observed when comparing duration of remission of CR prior to relapse: ≤
18 months: 33.2%; 18 – 36 months: 66.7% and > 36 months:
87.5% , this difference in survival outcomes found to be statistically
significant at p-value < 0.05 . The same trend of statistical
significance (p- value <0.05) observed when comparing OS at
3-years based on risk stratification at relapse: LR: 83.3%; IR: 80%
and HR: 44.8%. However, when the OS was compared at 3 years for site of
relapse no statistical significance observed: Extramedullary relapse
(CNS / testis):83.3%; BM: 56.7% and combined sites (B< + CNS
/ BM + testis): 62.5%. The above-mentioned survival outcomes are
summarized in Figure 1 as Kaplan meier curves.