Long-term results of the children's cancer group studies for childhood acute lymphoblastic leukemia 1983-2002: A Children's Oncology Group Report

被引：209

作者：

Gaynon, P. S. ^{[1
,2
]}

Angiolillo, A. L. ^{[3
]}

Carroll, W. L. ^{[4
]}

Nachman, J. B. ^{[5
]}

Trigg, M. E. ^{[6
]}

Sather, H. N. ^{[7
]}

Hunger, S. P. ^{[8
,9
]}

Devidas, M. ^{[10
,11
]}

机构：

[1] Childrens Hosp Los Angeles, Childrens Ctr Canc & Blood Dis, Los Angeles, CA 90027 USA

[2] Univ So Calif, Keck Sch Med, Dept Pediat, Los Angeles, CA 90033 USA

[3] Childrens Natl Med Ctr, Dept Pediat, Washington, DC 20010 USA

[4] Univ Chicago, Dept Pediat, Chicago, IL 60637 USA

[5] NYU, Dept Pediat, New York, NY 10016 USA

[6] Thomas Jefferson Univ, Jefferson Med Coll, Dept Pediat, Philadelphia, PA 19107 USA

[7] Univ So Calif, Keck Sch Med, Dept Preventat Med, Los Angeles, CA 90033 USA

[8] Univ Colorado Denver, Sch Med, Dept Pediat, Aurora, CO USA

[9] Childrens Hosp, Aurora, CO USA

[10] Univ Florida, Coll Med, Dept Epidemiol & Hlth Policy Res, Gainesville, FL USA

[11] Childrens Oncol Grp, Gainesville, FL USA

来源：

LEUKEMIA | 2010年 / 24卷 / 02期

基金：

美国国家卫生研究院;

关键词：

acute lymphoblastic leukemia; children; randomized clinical trials; MINIMAL RESIDUAL DISEASE; EVENT-FREE SURVIVAL; TRIAL AIEOP-BFM; HIGH-RISK; STANDARD-RISK; PROGNOSTIC-FACTORS; INTRATHECAL METHOTREXATE; DELAYED INTENSIFICATION; BONE-MARROW; PRESENTING FEATURES;

D O I：

10.1038/leu.2009.262

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The Children's Cancer Group enrolled 13 298 young people age <21 years on 1 of 16 protocols between 1983 and 2002. Outcomes were examined in three time periods, 1983-1988, 1989-1995, 1996-2002. Over the three intervals, 10-year event-free survival (EFS) for Rome/National Cancer Institute standard risk (SR) and higher risk (HR) B-precursor patients was 68 and 58%, 77 and 63%, and 78 and 67%, respectively, whereas for SR and HR T-cell patients, EFS was 65 and 56%, 78 and 68%, and 70 and 72%, respectively. Five-year EFS for infants was 36, 38, and 43%, respectively. Seminal randomized studies led to a number of important findings. Stronger post-induction intensification improved outcome for both SR and HR patients. With improved systemic therapy, additional intrathecal (IT) methotrexate effectively replaced cranial radiation. For SR patients receiving three-drug induction, iso-toxic substitution of dexamethasone for prednisone improved EFS. Pegylated asparaginase safely and effectively replaced native asparaginase. Thus, rational therapy modifications yielded better outcomes for both SR and HR patients. These trials provide the platforms for current Children's Oncology Group trials. Leukemia (2010) 24, 285-297; doi: 10.1038/leu.2009.262; published online 17 December 2009

引用

页码：285 / 297

页数：13

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