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Long-term results of Total Therapy studies 11, 12 and 13A for childhood acute lymphoblastic leukemia at St Jude Children's Research Hospital
- Source :
- Leukemia. 14(12)
- Publication Year :
- 2001
-
Abstract
- We present the long-term results of three consecutive clinical trials (Total Therapy studies 11, 12 and 13A) conducted for children with newly diagnosed acute lymphoblastic leukemia (ALL) between 1984 and 1994. In study 11 (1984-1988), the overall event-free survival rates (+/-1 s.e.) were 71.8 +/- 2.4% and 69.3 +/- 2.4%, and the cumulative risks of isolated central nervous system (CNS) relapse 5.6 +/- 1.2% and 5.9 +/- 1.3%, at 5 and 10 years, respectively. In study 12 (1988-1991), event-free survival rates were 67.6 +/- 3.4% and 61.5+/- 9.0%, and isolated CNS relapse rates were 10.4 +/- 2.3% and 10.4 +/- 2.3%, respectively. Early intensive intrathecal therapy in study 13A (1991-1994) has yielded a very low 5-year isolated CNS relapse rate of 1.2 +/- 0.9%, boosting the 5-year event-free survival rate to 76.9 +/- 3.3%. Factors consistently associated with an adverse prognosis included male sex, infant or adolescent age group, leukocyte count >100 x 10(9)/l, nonhyperdiploidy karyotype and poor early response to treatment. Risk classification based on age and leukocyte count had prognostic significance in B-lineage but not T-lineage ALL. Early therapeutic interventions or modifications for patients with specific genetic abnormalities or persistent minimal residual leukemia may further improve long-term results.
- Subjects :
- Male
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Gastroenterology
Central Nervous System Neoplasms
Internal medicine
Acute lymphocytic leukemia
medicine
Humans
Child
Survival rate
Childhood Acute Lymphoblastic Leukemia
Chemotherapy
business.industry
Remission Induction
Infant
Hematology
Precursor Cell Lymphoblastic Leukemia-Lymphoma
medicine.disease
Combined Modality Therapy
Surgery
Clinical trial
Radiation therapy
Survival Rate
Leukemia
Treatment Outcome
Oncology
El Niño
Child, Preschool
Female
business
Subjects
Details
- ISSN :
- 08876924
- Volume :
- 14
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Leukemia
- Accession number :
- edsair.doi.dedup.....9360ef0e2da5a09b8970d92efd4e68a3