Early postinduction intensification therapy improves survival for children and adolescents with high-risk acute lymphoblastic leukemia: A report from the children's oncology group Journal Article
| Authors: | Seibel, N. L.; Steinherz, P. G.; Sather, H. N.; Nachman, J. B.; Delaat, C.; Ettinger, L. J.; Freyer, D. R.; Mattano, L. A. Jr; Hastings, C. A.; Rubin, C. M.; Bertolone, K.; Franklin, J. L.; Heerema, N. A.; Mitchell, T. L.; Pyesmany, A. F.; La, M. K.; Edens, C.; Gaynon, P. S. |
| Article Title: | Early postinduction intensification therapy improves survival for children and adolescents with high-risk acute lymphoblastic leukemia: A report from the children's oncology group |
| Abstract: | Longer and more intensive postinduction intensification (PII) improved the outcome of children and adolescents with "higher risk" acute lymphoblastic leukemia (ALL) and a slow marrow response to induction therapy. In the Children's Cancer Group study (CCG-1961), we tested longer versus more intensive PII, using a 2 × 2 factorial design for children with higher risk ALL and a rapid marrow response to induction therapy. Between November 1996 and May 2002, 2078 children and adolescents with newly diagnosed ALL (1 to 9 years old with white blood count 50 000/mm3 or more, or 10 years of age or older with any white blood count) were enrolled. After induction, 1299 patients with marrow blasts less than or equal to 25% on day 7 of induction (rapid early responders) were randomized to standard or longer duration (n = 651 + 648) and standard or increased intensity (n = 649 + 650) PII. Stronger intensity PII improved event-free survival (81% vs 72%, P <.001) and survival (89% vs 83%, P =.003) at 5 years. Differences were most apparent after 2 years from diagnosis. Longer duration PII provided no benefit. Stronger intensity but not prolonged duration PII improved outcome for patients with higher-risk ALL. This study is registered at http://clinicaltrials.gov as NCT00002812. © 2008 by The American Society of Hematology. |
| Keywords: | cancer survival; controlled study; event free survival; treatment outcome; disease-free survival; survival rate; major clinical study; clinical trial; mortality; doxorubicin; antineoplastic agents; disease free survival; cytarabine; methotrexate; outcome assessment; follow up; follow-up studies; antineoplastic agent; controlled clinical trial; randomized controlled trial; antineoplastic combined chemotherapy protocols; risk factors; cyclophosphamide; dexamethasone; vincristine; risk factor; acute lymphoblastic leukemia; high risk patient; time; time factors; prednisolone; remission; remission induction; asparaginase; precursor cell lymphoblastic leukemia-lymphoma; lymphatic leukemia; tioguanine; mercaptopurine; asparaginase macrogol |
| Journal Title: | Blood |
| Volume: | 111 |
| Issue: | 5 |
| ISSN: | 0006-4971 |
| Publisher: | American Society of Hematology |
| Date Published: | 2008-03-01 |
| Start Page: | 2548 |
| End Page: | 2555 |
| Language: | English |
| DOI: | 10.1182/blood-2007-02-070342 |
| PUBMED: | 18039957 |
| PROVIDER: | scopus |
| PMCID: | PMC2254538 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 52" - "Export Date: 17 November 2011" - "CODEN: BLOOA" - "Source: Scopus" |
