Efficacy and safety of three-drug induction-based MASPORE 2003 chemotherapy protocol in standard- and intermediate-risk pediatric acute lymphoblastic leukemia: a decade-long single-center experience from India.
In a single-center retrospective Indian cohort, 137 children with standard- or intermediate-risk ALL treated using MASPORE 2003 had 8.76% relapse and 2.91% treatment-related mortality, while the 118 patients with at least two years of follow-up had 92.7% overall survival and 87.2% event-free survival.
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In a single-center retrospective Indian cohort, 137 children with standard- or intermediate-risk ALL treated using MASPORE 2003 had 8.76% relapse and 2.91% treatment-related mortality, while the 118 patients with at least two years of follow-up had 92.7% overall survival and 87.2% event-free survival.
Research significance
The cohort provides clinical evidence that an anthracycline-free induction and reduced-intensity reinduction protocol can be implemented with favorable observed outcomes in a resource-constrained setting; it supports, but does not establish, the hypothesis that this approach may reduce toxicity and treatment abandonment without materially compromising disease control compared with more intensive regimens.
Source abstract
Acute lymphoblastic leukemia (ALL), the most common childhood cancer, shows >90% survival in high-income settings but poorer outcomes in low- and middle-income regions due to increased infection rates, toxicity, and treatment abandonment. This single-center retrospective study from January 2016 to June 2025, analyzed outcomes of pediatric ALL patients treated with MASPORE 2003 protocol. Among 164 children, 137 met inclusion criteria. Relapse was observed in 8.76%, with treatment-related mortality of 2.91%. Among patients with ≥2 years follow-up (n = 118), OS and EFS were 92.7% and 87.2%, respectively. The protocol's anthracycline-free induction and reduced-intensity reinduction achieved favorable survival with lower toxicity and treatment abandonment in a LMIC.