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Outcome of risk-based therapy for infant acute lymphoblastic leukemia with or without an MLL gene rearrangement, with emphasis on late effects: a final report of two consecutive studies, MLL96 and MLL98, of the Japan Infant Leukemia Study Group
- Source :
- Leukemia. 21:2258-2263
- Publication Year :
- 2007
- Publisher :
- Springer Science and Business Media LLC, 2007.
-
Abstract
- We evaluated the efficacy of a treatment strategy in which infants with acute lymphoblastic leukemia (ALL) were stratified by their MLL gene status and then assigned to different risk-based therapies. A total of 102 patients were registered on two consecutive multicenter trials, designated MLL96 and MLL98, between 1995 and 2001. Those with a rearranged MLL gene (MLL-R, n=80) were assigned to receive intensive chemotherapy followed by hematopoietic stem cell transplantation (HSCT), while those with germline MLL (MLL-G, n=22) were treated with chemotherapy alone. The 5-year event-free survival (EFS) rate for all 102 infants was 50.9% (95% confidence interval, 41.0-60.8%). The most prominent late effect was growth impairment, observed in 58.9% of all evaluable patients in the MLL-R group. This plan of risk-based therapy appears to have improved the overall prognosis for infants with ALL, compared with previously reported results. However, over half the events in patients with MLL rearrangement occurred before the instigation of HSCT, and that HSCT-related toxic events comprised 36.3% (8/22) of post-transplantation events, suggesting that further stratification within the MLL-R group and the development of more effective early-phase intensification chemotherapy will be needed before the full potential of this strategy is realized.
- Subjects :
- Male
Risk
Oncology
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Antineoplastic Agents
Hematopoietic stem cell transplantation
Disease-Free Survival
Cytogenetics
Japan
hemic and lymphatic diseases
Acute lymphocytic leukemia
Internal medicine
Humans
Medicine
neoplasms
Gene Rearrangement
Acute leukemia
Chemotherapy
Hematology
business.industry
Remission Induction
Infant, Newborn
Late effect
Infant
Gene rearrangement
Precursor Cell Lymphoblastic Leukemia-Lymphoma
medicine.disease
Infant Acute Lymphoblastic Leukemia
Surgery
Treatment Outcome
Female
medicine.symptom
business
Stem Cell Transplantation
Subjects
Details
- ISSN :
- 14765551 and 08876924
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Leukemia
- Accession number :
- edsair.doi.dedup.....5c5706bfca7903c163cde144ed6d7b6e