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Childhood Acute Lymphoblastic Leukemia: Results of the Randomized Acute Lymphoblastic Leukemia Intercontinental-Berlin-Frankfurt-Münster 2009 Trial
M. Campbell, C. Kiss, M. Zimmermann, C. Riccheri, J. Kowalczyk, MS. Felice, M. Kuzmanovic, G. Kovacs, H. Kosmidis, A. Gonzalez, E. Bilic, L. Castillo, A. Kolenova, J. Jazbec, A. Popa, D. Konstantinov, J. Kappelmayer, T. Szczepanski, M. Dworzak,...
Jazyk angličtina Země Spojené státy americké
Typ dokumentu randomizované kontrolované studie, časopisecké články, práce podpořená grantem
NLK
Free Medical Journals
od 2004 do Před 1 rokem
Open Access Digital Library
od 1999-01-01
PubMed
37141547
DOI
10.1200/jco.22.01760
Knihovny.cz E-zdroje
- MeSH
- akutní lymfatická leukemie * MeSH
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- methotrexát terapeutické užití MeSH
- pre-B-buněčná leukemie * farmakoterapie MeSH
- přežití bez známek nemoci MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- rizikové faktory MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
PURPOSE: The International Berlin-Frankfurt-Münster (BFM) study group conducted a study on pediatric acute lymphoblastic leukemia (ALL). Minimal residual disease (MRD) was assessed using flow cytometry (FCM), and the impact of early intensification and methotrexate (MTX) dose on survival was evaluated. PATIENTS AND METHODS: We included 6,187 patients younger than 19 years. MRD by FCM refined the risk group definition previously used in the ALL intercontinental-BFM 2002 study on the basis of age, WBC count, unfavorable genetic aberrations, and treatment response measured morphologically. Patients at intermediate risk (IR) and high risk (HR) were randomly assigned to protocol augmented protocol I phase B (IB) versus IB regimen. MTX doses of 2 versus 5 g/m2 every 2 weeks, four times, were evaluated in precursor B-cell-ALL (pcB-ALL) IR. RESULTS: The 5-year event-free survival (EFS ± SE) and overall survival (OS ± SE) rates were 75.2% ± 0.6% and 82.6% ± 0.5%, respectively. Their values in risk groups were standard risk (n = 624), 90.7% ± 1.4% and 94.7% ± 1.1%; IR (n = 4,111), 77.9% ± 0.7% and 85.7% ± 0.6%; and HR (n = 1,452), 60.8% ± 1.5% and 68.4% ± 1.4%, respectively. MRD by FCM was available in 82.6% of cases. The 5-year EFS rates in patients randomly assigned to protocol IB (n = 1,669) and augmented IB (n = 1,620) were 73.6% ± 1.2% and 72.8% ± 1.2%, respectively (P = .55), while those in patients receiving MTX doses of 2 g/m2 (n = 1,056) and MTX 5 g/m2 (n = 1,027) were 78.8% ± 1.4% and 78.9% ± 1.4%, respectively (P = .84). CONCLUSION: The MRDs were successfully assessed using FCM. An MTX dose of 2 g/m2 was effective in preventing relapse in non-HR pcB-ALL. Augmented IB showed no advantages over the standard IB.[Media: see text].
2nd Department of Pediatrics Semmelweis University Budapest Hungary
Argentine Group for the Treatment of Acute Leukemia GATLA Buenos Aires Argentina
Centro Tettamanti Fondazione IRCCS San Gerardo dei Tintori Monza Italy
Department of Laboratory Medicine Faculty of Medicine University of Debrecen Debrecen Hungary
Department of Pediatric Hematology and Oncology Hannover Medical School Hannover Germany
Department of Pediatric Hematology and Oncology Zabrze Medical University of Silesia Katowice Poland
Hospital del Salvador Universidad de Chile Santiago Chile
Institute of Hematology and Immunology Pediatric Clinic Havana Cuba
Mother and Child Health Care Institute of Serbia Dr Vukan Cupic Faculty of Medicine Belgrade Serbia
Pediatric and Adolescent Oncology Clinic Children's Hospital MITERA Athens Greece
Citace poskytuje Crossref.org
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