Risk-adjusted therapy for pediatric non-T cell ALL improves outcomes for standard risk patients: results of JACLS ALL-02
| Autor: | Daiichiro Hasegawa, Toshihiko Imamura, Keiko Yumura-Yagi, Yoshihiro Takahashi, Ikuya Usami, So-ichi Suenobu, Shinichiro Nishimura, Nobuhiro Suzuki, Yoshiko Hashii, Takao Deguchi, Akiko Moriya-Saito, Koji Kato, Yoshiyuki Kosaka, Masahiro Hirayama, Akihiro Iguchi, Hirohide Kawasaki, Hiroki Hori, Atsushi Sato, Tooru Kudoh, Tatsutoshi Nakahata, Megumi Oda, Junichi Hara, Keizo Horibe, for the Japan Association of Childhood Leukemia Study Group (JACLS) |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Childhood leukemia lcsh:RC254-282 Article law.invention Central Nervous System Neoplasms Randomized controlled trial law Multicenter trial White blood cell Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Combined Modality Therapy Cumulative incidence Child Survival rate Acute lymphocytic leukaemia business.industry Infant Hematology Precursor Cell Lymphoblastic Leukemia-Lymphoma Prognosis medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Survival Rate Log-rank test medicine.anatomical_structure Oncology Child Preschool Randomized controlled trials Female Risk Adjustment Cranial Irradiation Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Blood Cancer Journal, Vol 10, Iss 2, Pp 1-11 (2020) Blood Cancer Journal |
| ISSN: | 2044-5385 |
| Popis: | This study was a second multicenter trial on childhood ALL by the Japan Childhood Leukemia Study Group (JACLS) to improve outcomes in non-T ALL. Between April 2002 and March 2008, 1138 children with non-T ALL were enrolled in the JACLS ALL-02 trial. Patients were stratified into three groups using age, white blood cell count, unfavorable genetic abnormalities, and treatment response: standard risk (SR), high risk (HR), and extremely high risk (ER). Prophylactic cranial radiation therapy (PCRT) was abolished except for CNS leukemia. Four-year event-free survival (4yr-EFS) and 4-year overall survival (4yr-OS) rates for all patients were 85.4% ± 1.1% and 91.2% ± 0.9%, respectively. Risk-adjusted therapy resulted in 4yr-EFS rates of 90.4% ± 1.4% for SR, 84.9% ± 1.6% for HR, and 66.5% ± 4.0% for ER. Based on NCI risk classification, 4yr-EFS rates were 88.2% in NCI-SR and 76.4% in NCI-HR patients, respectively. Compared to previous trial ALL-97, 4yr-EFS of NCI-SR patients was significantly improved (88.2% vs 81.2%, log rank p = 0.0004). The 4-year cumulative incidence of isolated (0.9%) and total (1.5%) CNS relapse were significantly lower than those reported previously. In conclusion, improved EFS in NCI-SR patients and abolish of PCRT was achieved in ALL-02. |
| Databáze: | OpenAIRE |
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