[The prospects for children with acute lymphoblastic leukemia of being cured has increased in the Czech Republic in the 21st century to 90% - outcome of the ALL-IC BFM 2002 trial].

Autor:	Zdráhalová K, Štěrba J, Domanský J, Blažek B, Ptoszková H, Mihál V, Novák Z, Hak J, Procházková D, Černá Z, Timr P, Jabali Y, Sedláček P, Smíšek P, Zemanová Z, Jarošová M, Houdková A, Mejstříková E, Hrušák O, Zuna J, Janotová I, Trka J, Starý J
Jazyk:	čeština
Zdroj:	Casopis lekaru ceskych [Cas Lek Cesk] 2015; Vol. 154 (2), pp. 79-89.
Abstrakt:	Background: Acute lymphoblastic leukemia (ALL) is the most frequent childhood malignancy. Treatment has been unified in the middle of 1980 in the Czech Republic. In 2002-2007 children and adolescents with acute lymphoblastic leukemia were treated in an international randomized trial ALL-IC BFM 2002 in the Czech Republic. 291 patients aged 1-18 years were enrolled; infants below 1 year entered a separate trial. Methods and Results: Patients were stratified into three risk groups according to their age, initial leukocyte count, prednisone response, presence of fusion genes BCR/ABL or MLL/AF4, bone marrow D+15 and remission status D+33. The whole therapy took 24 months. Randomized late intensification compared standard BFM therapy with extended, usually more intensive experimental treatment. The median follow-up was 8.7 years. Complete remission was achieved in 97.9% patients, 1% died in remission. 11% of children relapsed, 1.7% with CNS involvement. Six children (2.1%) developed secondary malignancy. Event free survival (EFS) 8 years from diagnosis was 83.5%, overall survival (OS) 91.4%. EFS and OS of the risk groups were: standard risk: 89.4%; 98.1%; intermediate risk: 82.6%; 89.6%; high risk: 68.8%; 78.1%. Male sex and age above 10 years were adverse prognostic factors. Conclusions: In comparison with the previous trial ALL-BFM 95, significant improvement was achieved.
Databáze:	MEDLINE
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