Early postinduction intensification therapy improves survival for children and adolescents with high-risk acute lymphoblastic leukemia: a report from the Children's Oncology Group. Academic Article uri icon

Overview

abstract

  • Longer and more intensive postinduction intensification (PII) improved the outcome of children and adolescents with "higher risk" acute lymphoblastic leukemia (ALL) and a slow marrow response to induction therapy. In the Children's Cancer Group study (CCG-1961), we tested longer versus more intensive PII, using a 2 x 2 factorial design for children with higher risk ALL and a rapid marrow response to induction therapy. Between November 1996 and May 2002, 2078 children and adolescents with newly diagnosed ALL (1 to 9 years old with white blood count 50 000/mm3 or more, or 10 years of age or older with any white blood count) were enrolled. After induction, 1299 patients with marrow blasts less than or equal to 25% on day 7 of induction (rapid early responders) were randomized to standard or longer duration (n = 651 + 648) and standard or increased intensity (n = 649 + 650) PII. Stronger intensity PII improved event-free survival (81% vs 72%, P < .001) and survival (89% vs 83%, P = .003) at 5 years. Differences were most apparent after 2 years from diagnosis. Longer duration PII provided no benefit. Stronger intensity but not prolonged duration PII improved outcome for patients with higher-risk ALL. This study is registered at http://clinicaltrials.gov as NCT00002812.

authors

  • Seibel, Nita L
  • Steinherz, Peter G
  • Sather, Harland N
  • Nachman, James B
  • Delaat, Cynthia
  • Ettinger, Lawrence J
  • Freyer, David R
  • Mattano, Leonard A
  • Hastings, Caroline A
  • Rubin, Charles M
  • Bertolone, Kathy
  • Franklin, Janet L
  • Heerema, Nyla A
  • Mitchell, Torrey L
  • Pyesmany, Allan F
  • La, Mei K
  • Edens, Cheryl
  • Gaynon, Paul S

publication date

  • November 26, 2007

Research

keywords

  • Precursor Cell Lymphoblastic Leukemia-Lymphoma

Identity

PubMed Central ID

  • PMC2254538

Scopus Document Identifier

  • 41949098006

Digital Object Identifier (DOI)

  • 10.1182/blood-2007-02-070342

PubMed ID

  • 18039957

Additional Document Info

volume

  • 111

issue

  • 5