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Remission, treatment failure, and relapse in pediatric ALL: an international consensus of the Ponte-di-Legno Consortium
S. Buchmann, M. Schrappe, A. Baruchel, A. Biondi, M. Borowitz, M. Campbell, G. Cario, G. Cazzaniga, G. Escherich, CJ. Harrison, M. Heyman, SP. Hunger, C. Kiss, HC. Liu, F. Locatelli, ML. Loh, A. Manabe, G. Mann, R. Pieters, CH. Pui, S. Rives, K....
Language English Country United States
Document type Journal Article, Research Support, Non-U.S. Gov't
Grant support
P30 CA021765
NCI NIH HHS - United States
U10 CA180886
NCI NIH HHS - United States
U10 CA180899
NCI NIH HHS - United States
NLK
Free Medical Journals
from 1946 to 1 year ago
Freely Accessible Science Journals
from 1946 to 1 year ago
Open Access Digital Library
from 1946-01-01
Open Access Digital Library
from 1946-01-01
ROAD: Directory of Open Access Scholarly Resources
- MeSH
- Precursor Cell Lymphoblastic Leukemia-Lymphoma * drug therapy therapy MeSH
- Child MeSH
- Remission Induction MeSH
- Consensus MeSH
- Humans MeSH
- Treatment Failure MeSH
- Pons MeSH
- Recurrence MeSH
- Neoplasm, Residual diagnosis MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Comparison of treatment strategies in de novo pediatric acute lymphoblastic leukemia (ALL) requires standardized measures of efficacy. Key parameters that define disease-related events, including complete remission (CR), treatment failure (TF; not achieving CR), and relapse (loss of CR) require an updated consensus incorporating modern diagnostics. We collected the definitions of CR, TF, and relapse from recent and current pediatric clinical trials for the treatment of ALL, including the key components of response evaluation (timing, anatomic sites, detection methods, and thresholds) and found significant heterogeneity, most notably in the definition of TF. Representatives of the major international ALL clinical trial groups convened to establish consensus definitions. CR should be defined at a time point no earlier than at the end of induction and should include the reduction of blasts below a specific threshold in bone marrow and extramedullary sites, incorporating minimal residual disease (MRD) techniques for marrow evaluations. TF should be defined as failure to achieve CR by a prespecified time point in therapy. Relapse can only be defined in patients who have achieved CR and must include a specific threshold of leukemic cells in the bone marrow confirmed by MRD, the detection of central nervous system leukemia, or documentation of extramedullary disease. Definitions of TF and relapse should harmonize with eligibility criteria for clinical trials in relapsed/refractory ALL. These consensus definitions will enhance the ability to compare outcomes across pediatric ALL trials and facilitate development of future international collaborative trials.
Chilean National Pediatric Oncology Group Santiago Chile
Department of Oncology St Jude Children's Research Hospital Memphis TN
Department of Pediatric Oncology Dana Farber Cancer Institute Boston MA
Department of Pediatrics Hokkaido University Graduate School of Medicine Sapporo Japan
Department of Pediatrics University Medical Center Schleswig Holstein Kiel Germany
Great Ormond Street Hospital London United Kingdom
Japan Children's Cancer Group Japan Sapporo Japan
Johns Hopkins Kimmel Cancer Center Baltimore MD
Princess Maxima Center for Pediatric Oncology Utrecht The Netherlands
University Hospital Motol 2nd Faculty of Medicine Charles University Prague Czech Republic
References provided by Crossref.org
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