Randomized assessment of delayed intensification and two methods for parenteral methotrexate delivery in childhood B-ALL: Children’s Oncology Group Studies P9904 and P9905
Autor: | Paul L. Martin, William L. Carroll, Bruce M. Camitta, Michael J. Borowitz, W. Paul Bowman, Jonathan J. Shuster, Stephen P. Hunger, Jeanette Pullen, Cheryl L. Willman, Meenakshi Devidas, Naomi J. Winick, Andrew J. Carroll, Eric Larsen |
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Rok vydání: | 2019 |
Předmět: |
Male
0301 basic medicine Oncology Cancer Research Neoplasm Residual Time Factors Dexamethasone Random Allocation 0302 clinical medicine Prednisone Antineoplastic Combined Chemotherapy Protocols Child Mercaptopurine Drug Administration Routes Remission Induction Cytarabine Hematology Precursor Cell Lymphoblastic Leukemia-Lymphoma Treatment Outcome Childhood B-ALL Vincristine Child Preschool 030220 oncology & carcinogenesis Female medicine.drug medicine.medical_specialty Randomization Adolescent Article Drug Administration Schedule Young Adult 03 medical and health sciences Internal medicine medicine Overall survival Asparaginase Humans Cyclophosphamide business.industry Daunorubicin Infant Cancer medicine.disease Survival Analysis Minimal residual disease Methotrexate 030104 developmental biology business |
Zdroj: | Leukemia |
ISSN: | 1476-5551 0887-6924 |
Popis: | The delayed intensification (DI) enhanced outcome for patients with acute lymphoblastic leukemia (ALL) treated on BFM 76/79 and CCG 105 after a prednisone-based induction. Childrens Oncology Group protocols P9904/9905 evaluated DI via a post-induction randomization for eligible National Cancer Institute (NCI) standard (SR) and high-risk (HR) patients. A second randomization compared intravenous methotrexate (IV MTX) as a 24- (1 g/m(2)) vs. 4-h (2 g/m(2)) infusion. NCI SR patients received a dexamethasone-based three-drug and NCI HR/CNS 3 SR patients a prednisone-based four-drug induction. End induction MRD (minimal residual disease) was obtained but did not impact treatment. DI improved the 10-year continuous complete remission (CCR) rate; 75.5 ± 2.5% vs. 81.8 ± 2.2% p = 0.002, whereas MTX administration did not; 4-h 80.8 ± 1.9%; 24-h 81.4 ± 1.9% (p = 0.7780). Overall survival (OS) at 10 years did not differ with DI: 91.4 ± 1.6% vs. 90.9 ± 1.7% (p = 0.25) without but was higher with the 24-h MTX infusion; 4-h 91.1 ± 1.4%; 24-h 93.9 ± 1.2% (p = 0.0209). MRD predicted outcome; 10-year CCR 87.7 ± 2.2 and 82.1 ± 2.5% when MRD was |
Databáze: | OpenAIRE |
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