[Age-related characteristics of the efficacy of different glucocorticosteroids in the therapy of acute lymphoblastic leukemia].

Autor:	Karachunsky AI; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia., Rumyantseva YV; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia., Lagoiko SN; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia., Bührer C; Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany., Tallen G; Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany., Aleinikova OV; Republican Research and Practical Center for Pediatric Oncology and Hematology, Minsk, Belarus., Bydanov OI; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; Republican Research and Practical Center for Pediatric Oncology and Hematology, Minsk, Belarus., Korepanova NV; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia., Baidun LV; Russian Children's Clinical Hospital, Ministry of Health of Russia, Moscow, Russia., Nasedkina TV; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia., Stackelberg AV; Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany., Novichkova GA; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia., Maschan AA; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia., Litvinov DV; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia., Ponomareva NI; Russian Children's Clinical Hospital, Ministry of Health of Russia, Moscow, Russia., Kondratchik KL; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia; Morozov City Children's Clinical Hospital, Moscow Healthcare Department, Moscow, Russia., Mansurova EG; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia., Fechina LG; Regional Children's Clinical Hospital One, Yekaterinburg, Russia., Streneva OV; Regional Children's Clinical Hospital One, Yekaterinburg, Russia., Yudina NB; Voronezh Regional Children's Clinical Hospital One, Voronezh, Russia., Sharapova GR; Nizhnevartovsk District Children's Clinical Hospital, Nizhnevartovsk, Khanty-Mansi Autonomic District-Yugra, Russia., Shamardina AV; Nizhny Novgorod Regional Children's Clinical Hospital, Nizhny Novgorod, Russia., Gerbek IE; Tomsk Regional Clinical Hospital, Tomsk, Russia., Shapochnik AP; Orenburg Regional Clinical Oncology Dispensary, Orenburg, Russia., Rumyantsev AG; D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia., Henze G; Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany.
Jazyk:	ruština
Zdroj:	Terapevticheskii arkhiv [Ter Arkh] 2015; Vol. 87 (7), pp. 41-50.
DOI:	10.17116/terarkh201587741-50
Abstrakt:	Aim: To determine predictors for decision-making on a differential approach to choosing glucocorticosteroids (GCS) for children and adolescents with acute lymphoblastic leukemia (ALL). Subjects and Methods: The analysis covered 1064 primary patients aged to 1 to 18 years with ALL who had been registered at the clinics of Russia and Belorussia in April 2002 to November 2006. Before induction therapy, the patients were randomized into a dexamethasone (DEXA) 6 mg/m2 group (n=539) and a methylprednisolone (MePRED) 60 mg/m2 one (n=525). Results: The entire group showed no statistically significant differences in survival rates between the patients receiving DEXA or MePRED. However, an analysis of age groups revealed the benefits of DEXA in children younger than 14 years (the event-free survival (EFS) was 76±2 and 71±2%, respectively (p=0.048); the overall survival (OS) was 81±2 and 77±2%, respectively (p=0.046); therapy-induced mortality was 6.4% (DEXA) andl 1.1% (MePRED) (p=0.01 4); the rate of isolated extramedullary relapses was 1.5% (DEXA) and 4.4% (MePRED) (p=0.009). At the same time, EFS and OS in 14-to-18-year-old adolescents were statistically significantly higher than in those who used MePRED (EFS, 65±6 and 52±6%, respectively (p=0.087); OS, 72±6 and 61±6%, respectively; (p=0.l 7). Conclusion: The findings suggest that it is possible that the choice of a GCS for ALL therapy must be also based on a patient's age. There is a need for further studies of this matter in prospective randomized multicenter trials in children and adolescents.
Databáze:	MEDLINE
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