Improved Clinical Outcome for Children with T-Lineage Acute Lymphoblastic Leukemia After Contemporary Chemotherapy:A Children's Cancer Group Study
| Autor: | David G. Tubergen, Fatih M. Uckun, G Reaman, Harland Sather, Peter G. Steinherz, Diane C. Arthur, Michael E. Trigg, Paul S. Gaynon |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Lineage (genetic) Adolescent medicine.medical_treatment Lymphoblastic Leukemia Intensive chemotherapy Disease-Free Survival Immunophenotyping hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Leukemia-Lymphoma Adult T-Cell Child Intensive care medicine Chemotherapy Group study business.industry Infant Cancer hemic and immune systems Hematology Prognosis medicine.disease Treatment Outcome Child Preschool Female business |
| Zdroj: | Leukemia & Lymphoma. 24:57-70 |
| ISSN: | 1029-2403 1042-8194 |
| DOI: | 10.3109/10428199609045714 |
| Popis: | The prognostic importance of T-lineage acute lymphoblastic leukemia (ALL) in contemporary programs of intensive chemotherapy has been controversial. We therefore assessed the impact of this biological feature in risk-adjusted frontline chemotherapy studies of the Children's Cancer Group (CCG), conducted from 1983 to 1994. A substantially greater proportion of T-lineage patients (N = 730) presented with poor-risk features as compared to B-lineage patients (N = 3668) treated in the same studies (71.1% vs. 39.7%, P0.0001). Consequently, in the CCG-100 series of clinical trials (1983-1989), which tested regimens that were largely of moderate intensity, T-lineage ALL patients had an excess of adverse early events compared to patients in the B-lineage group: 3-year event-free survival (EFS) estimate, 65.8% vs 78.2% (P0.0001). With the introduction of more intensive chemotherapy in studies from 1989 to 1994 (CCG-1800 series). We observed a progressive and significant improvement in the clinical outcome of patients with T-lineage immunophenotype. Three- and 5-year EFS probabilities increased from 65.8% to 78.1% and from 61.0% to 75.2%, respectively, becoming comparable to or slightly better than results for B-lineage ALL patients. When adjusted for the competing effects of leukocyte count, age, organomegaly and other poor-risk features, T-lineage immunophenotype showed no important impact on the overall EFS pattern. These findings demonstrate the loss of adverse prognostic by T-lineage ALL in a large program of intensive chemotherapy developed over the past decade. |
| Databáze: | OpenAIRE |
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