Risk-adjusted therapy for pediatric non-T cell ALL improves outcomes for standard risk patients: results of JACLS ALL-02.
Adolescent
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Central Nervous System Neoplasms
/ mortality
Child
Child, Preschool
Combined Modality Therapy
Cranial Irradiation
/ mortality
Female
Follow-Up Studies
Humans
Infant
Male
Neoplasm Recurrence, Local
/ mortality
Precursor Cell Lymphoblastic Leukemia-Lymphoma
/ mortality
Prognosis
Risk Adjustment
/ methods
Survival Rate
Journal
Blood cancer journal
ISSN: 2044-5385
Titre abrégé: Blood Cancer J
Pays: United States
ID NLM: 101568469
Informations de publication
Date de publication:
27 02 2020
27 02 2020
Historique:
received:
29
11
2019
accepted:
07
02
2020
revised:
01
02
2020
entrez:
29
2
2020
pubmed:
29
2
2020
medline:
31
10
2020
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 32107374
doi: 10.1038/s41408-020-0287-4
pii: 10.1038/s41408-020-0287-4
pmc: PMC7046744
doi:
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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