Intensive chemotherapy for childhood acute lymphoblastic leukemia: results of the randomized intercontinental trial ALL IC-BFM 2002
| Autor: | Alejandro Gonzalez, Jan Stary, Giuseppe Masera, Y. Jabali, Dragana Janic, Hansjörg Riehm, Edina Magyarosy, Martin Zimmermann, Gabor G. Kovacs, Svetlana Donska, Batia Stark, Ondrej Hrusak, Josip Konja, Jan Trka, Martin Schrappe, Chi Kong Li, Eduardo Dibar, Janez Jazbec, Myriam Campbell, Emilia Kaiserova, Shai Izraeli, Alexander Popa, Jerzy Kowalczyk, Luis Castillo |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Cancer Research Pediatrics medicine.medical_specialty Treatment response Asia medicine.medical_treatment International Cooperation Hematopoietic stem cell transplantation Intensive chemotherapy Risk Assessment Disease-Free Survival law.invention Randomized controlled trial law Recurrence Risk Factors Antineoplastic Combined Chemotherapy Protocols Medicine Humans Prospective Studies Prospective cohort study Child Childhood Acute Lymphoblastic Leukemia lymhoblastic leukemia children chemotherapy Chemotherapy business.industry Hematopoietic Stem Cell Transplantation Infant Precursor Cell Lymphoblastic Leukemia-Lymphoma South America 3. Good health Europe Treatment Outcome Oncology Drug Resistance Neoplasm Child Preschool Female business Risk assessment |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 32(3) |
| ISSN: | 1527-7755 |
| Popis: | Purpose From 2002 to 2007, the International Berlin-Frankfurt-Münster Study Group conducted a prospective randomized clinical trial (ALL IC-BFM 2002) for the management of childhood acute lymphoblastic leukemia (ALL) in 15 countries on three continents. The aim of this trial was to explore the impact of differential delayed intensification (DI) on outcome in all risk groups. Patients and Methods For this trial, 5,060 eligible patients were divided into three risk groups according to age, WBC, early treatment response, and unfavorable genetic aberrations. DI was randomized as follows: standard risk (SR), two 4-week intensive elements (protocol III) versus one 7-week protocol II; intermediate risk (IR), protocol III × 3 versus protocol II × 1; high risk (HR), protocol III × 3 versus either protocol II × 2 (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP] option), or 3 HR blocks plus single protocol II (Berlin-Frankfurt-Münster [BFM] option). Results At 5 years, the probabilities of event-free survival and survival were 74% (± 1%) and 82% (± 1%) for all 5,060 eligible patients, 81% and 90% for the SR (n = 1,564), 75% and 83% for the IR (n = 2,650), and 55% and 62% for the HR (n = 846) groups, respectively. No improvement was accomplished by more intense and/or prolonged DI. Conclusion The ALL IC-BFM 2002 trial is a good example of international collaboration in pediatric oncology. A wide platform of countries able to run randomized studies in ALL has been established. Although the alternative DI did not improve outcome compared with standard treatment and the overall results are worse than those achieved by longer established leukemia groups, the national results have generally improved. |
| Databáze: | OpenAIRE |
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