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Outcome for Children and Young Adults With T-Cell ALL and Induction Failure in Contemporary Trials
EA. Raetz, P. Rebora, V. Conter, M. Schrappe, M. Devidas, G. Escherich, C. Imai, B. De Moerloose, K. Schmiegelow, MA. Burns, S. Elitzur, R. Pieters, A. Attarbaschi, A. Yeoh, CH. Pui, J. Stary, G. Cario, N. Bodmer, AV. Moorman, B. Buldini, A....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
Grantová podpora
U10 CA098413
NCI NIH HHS - United States
P30 CA021765
NCI NIH HHS - United States
U10 CA098543
NCI NIH HHS - United States
U10 CA180899
NCI NIH HHS - United States
U10 CA180886
NCI NIH HHS - United States
NLK
Free Medical Journals
od 2004 do Před 1 rokem
Open Access Digital Library
od 1999-01-01
PubMed
37487146
DOI
10.1200/jco.23.00088
Knihovny.cz E-zdroje
- MeSH
- akutní lymfatická leukemie * farmakoterapie MeSH
- dítě MeSH
- dospělí MeSH
- indukce remise MeSH
- lidé MeSH
- lymfoblastická leukemie-lymfom z prekurzorových T-buněk * terapie MeSH
- mladý dospělý MeSH
- přežití po terapii bez příznaků nemoci MeSH
- retrospektivní studie MeSH
- T-lymfocyty MeSH
- transplantace hematopoetických kmenových buněk * MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: Historically, patients with T-cell acute lymphoblastic leukemia (T-ALL) who fail to achieve remission at the end of induction (EOI) have had poor long-term survival. The goal of this study was to examine the efficacy of contemporary therapy, including allogeneic hematopoietic stem cell transplantation (HSCT) in first remission (CR1). METHODS: Induction failure (IF) was defined as the persistence of at least 5% bone marrow (BM) lymphoblasts and/or extramedullary disease after 4-6 weeks of induction chemotherapy. Disease features and clinical outcomes were reported in 325 of 6,167 (5%) patients age 21 years and younger treated in 14 cooperative study groups between 2000 and 2018. RESULTS: With a median follow-up period of 6.4 years (range, 0.3-17.9 years), the 10-year overall survival (OS) was 54.7% (SE = 2.9), which is significantly higher than the 27.6% (SE = 2.9) observed in the historical cohort from 1985 to 2000. There was no significant impact of sex, age, white blood cell count, central nervous system disease status, T-cell maturity, or BM disease burden at EOI on OS. Postinduction complete remission (CR) was achieved in 93% of patients with 10-year OS of 59.6% (SE = 3.1%) and disease-free survival (DFS) of 56.3% (SE = 3.1%). Among the patients who achieved CR, 72% underwent HSCT and their 10-year DFS (with a 190-day landmark) was significantly better than nontransplanted patients (63.8% [SE = 3.6] v 45.5% [SE = 7.1]; P = .005), with OS of 66.2% (SE = 3.6) versus 50.8% (SE = 6.8); P = .10, respectively. CONCLUSION: Outcomes for patients age 21 years and younger with T-ALL and IF have improved in the contemporary treatment era with a DFS benefit among those undergoing HSCT in CR1. However, outcomes still lag considerably behind those who achieve remission at EOI, warranting investigation of new treatment approaches.
Biostatistics and Clinical Epidemiology Fondazione IRCCS San Gerardo dei Tintori Monza Italy
Department of Global Pediatric Medicine St Jude Children's Research Hospital Memphis TN
Department of Haematology Great Ormond Street Hospital London United Kingdom
Department of Oncology St Jude Children's Research Hospital Memphis TN
Department of Paediatrics Yong Loo Lin School of Medicine National University of Singapore Singapore
Department of Pediatric Oncology Dana Farber Cancer Institute Harvard Medical School Boston MA
Department of Pediatrics and Perlmutter Cancer Center NYU Langone Health New York NY
Department of Woman and Child Health University of Padua Padua Italy
Institute of Clinical Medicine Faculty of Medicine University of Copenhagen Denmark
Pediatric Hematology and Oncology Kinderspital Zurich Zurich Switzerland
Pediatrics 1 University Medical Center Schleswig Holstein Campus Kiel Kiel Germany
Princess Máxima Center for Pediatric Oncology Utrecht the Netherlands
St Anna Children's Cancer Research Institute Vienna Austria
Tettamanti Center Fondazione IRCCS San Gerardo dei Tintori Monza Italy
Citace poskytuje Crossref.org
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