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
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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