1. Outcomes after late bone marrow and very early central nervous system relapse of childhood B-acute lymphoblastic leukemia: a report from the Children's Oncology Group phase III study AALL0433
- Author
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Lew, Glen, Chen, Yichen, Lu, Xiaomin, Rheingold, Susan R, Whitlock, James A, Devidas, Meenakshi, Hastings, Caroline A, Winick, Naomi J, Carroll, William L, Wood, Brent L, Borowitz, Michael J, Pulsipher, Michael A, and Hunger, Stephen P
- Subjects
Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Oncology and Carcinogenesis ,Clinical Trials and Supportive Activities ,Clinical Research ,Hematology ,Transplantation ,Pediatric Cancer ,Childhood Leukemia ,Pediatric Research Initiative ,Rare Diseases ,Orphan Drug ,Cancer ,Pediatric ,6.1 Pharmaceuticals ,4.2 Evaluation of markers and technologies ,Evaluation of treatments and therapeutic interventions ,Detection ,screening and diagnosis ,Good Health and Well Being ,Bone Marrow ,Central Nervous System ,Child ,Disease-Free Survival ,Humans ,Neoplasm ,Residual ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Prognosis ,Recurrence ,Treatment Outcome ,Cardiorespiratory Medicine and Haematology ,Immunology ,Cardiovascular medicine and haematology - Abstract
Outcomes after relapse of childhood B-acute lymphoblastic leukemia (B-ALL) are poor, and optimal therapy is unclear. Children's Oncology Group study AALL0433 evaluated a new platform for relapsed ALL. Between March 2007 and October 2013 AALL0433 enrolled 275 participants with late bone marrow or very early isolated central nervous system (iCNS) relapse of childhood B-ALL. Patients were randomized to receive standard versus intensive vincristine dosing; this randomization closed due to excess peripheral neuropathy in 2010. Patients with matched sibling donors received allogeneic hematopoietic cell transplantation (HCT) after the first three blocks of therapy. The prognostic value of minimal residual disease (MRD) was also evaluated in this study. The 3-year event free and overall survival (EFS/OS) for the 271 eligible patients were 63.6% +/- 3.0% and 72.3% +/- 2.8% respectively. MRD at the end of Induction-1 was highly predictive of outcome, with 3-year EFS/OS of 84.9 +/- 4.0% and 93.8 +/- 2.7% for patients with MRD
- Published
- 2021