CNS-3 status remains an independent adverse prognosis factor in children with acute lymphoblastic leukemia (ALL) treated without cranial irradiation: Results of EORTC Children Leukemia Group study 58951
| Autor: | Claire Freycon, Maryline Poiree, Philip Maes, Yves Benoit, Catherine Paillard, Yves Bertrand, N Sirvent, C. Pluchart, Claire Hoyoux, Pauline Simon, K. Yakouben, Alina Ferster, Hélène Cavé, Odile Minckes, P Rohrlich, A Uyttebroeck, Frédéric Millot, Stefan Suciu, B. De Moerloose, Françoise Mazingue, Vitor Costa, Geneviève Plat |
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| Přispěvatelé: | European Organisation for Research Treatment of Cancer |
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Central Nervous System Male medicine.medical_specialty Adolescent Lymphoblastic Leukemia Central nervous system Pediatrics 03 medical and health sciences 0302 clinical medicine Cranial Irradiation Predictive Value of Tests 030225 pediatrics Internal medicine medicine Biomarkers Tumor Humans Child Group study business.industry Incidence (epidemiology) Infant Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Prognosis Minimal residual disease Leukemia medicine.anatomical_structure Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Methotrexate Female Human medicine business medicine.drug |
| Zdroj: | Archives de pédiatrie |
| ISSN: | 1769-664X 0929-693X |
| Popis: | Aim To evaluate the prognostic significance of initial central nervous system (CNS) involvement of children with acute lymphoblastic leukemia (ALL) enrolled in the EORTC 58951 trial. Patients and methods From 1998 to 2008, 1930 ALL patients were included in the randomized EORTC 58951 trial. Overall treatment intensity was adjusted according to known prognostic factors including the level of minimal residual disease after induction treatment. CNS-directed therapy comprised four to 11 courses of i.v. methotrexate (5 g/m2), and 10 to 19 intrathecal chemotherapy injections, depending on risk group and CNS status. Cranial irradiation was omitted for all patients. Results The overall 8-year event-free survival (EFS) and overall survival (OS) rates were 81.3% and 88.1%, respectively. In the CNS-1, TPL+, CNS-2, and CNS-3 groups, the 8-year EFS rates were 82.1%, 77.1%, 78.3%, and 57.4%, respectively. Multivariable analysis indicated that initial CNS-3 status, but not CNS-2 or TLP+, was an independent adverse predictor of outcome. The 8-year incidence of isolated CNS relapse was 1.7% and of isolated or combined CNS relapse it was 3.7%. NCI high-risk group, male sex, CNS-2 and CNS-3 status were independent predictors for a higher incidence of any CNS relapse. Conclusions CNS-3 status remains associated with poor prognosis and requires intensification of both systemic and CNS-directed therapy. This trial was registered at https://clinicaltrials.gov/under/NCT00003728 . |
| Databáze: | OpenAIRE |
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