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Relapsed childhood ...
Relapsed childhood acute lymphoblastic leukemia in the Nordic countries : prognostic factors, treatment and outcome
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- Oskarsson, Trausti (author)
- Karolinska Institutet
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- Soderhall, Stefan (author)
- Karolinska Institutet
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- Arvidson, Johan, 1953- (author)
- Uppsala universitet,Pediatrik,Barnonkologisk forskning/Ljungman
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- Forestier, Erik (author)
- Umeå universitet,Pediatrik,Department of Pediatrics, Umeå University Hospital, Umeå, Sweden
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- Montgomery, Scott, 1961- (author)
- Örebro universitet,Institutionen för hälsovetenskap och medicin,Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, London, UK,Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Sweden
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- Bottai, Matteo (author)
- Karolinska Institutet
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- Lausen, Birgitte (author)
- Department of Pediatric Oncology, Rigshospitalet University Hospital, Copenhagen, Denmark
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- Carlsen, Niels (author)
- Department of Pediatrics, Odense University Hospital, Odense, Denmark
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- Hellebostad, Marit (author)
- Department of Pediatrics, Ullevål Hospital, Oslo, Norway
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- Lahteenmaki, Paivi (author)
- Department of Pediatrics, Turku University Hospital, Turku, Finland
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- Saarinen-Pihkala, Ulla M. (author)
- Children’s Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland,Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Finland
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- Jonsson, Olafur G. (author)
- Children’s Hospital, Landspitali University Hospital, Reykjavik, Iceland
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- Heyman, Mats (author)
- Karolinska Institutet
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(creator_code:org_t)
- 2015-10-22
- 2016
- English.
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In: Haematologica. - Pavia, Italy : Ferrata Storti Foundation (Haematologica). - 0390-6078 .- 1592-8721. ; 101:1, s. 68-76
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Abstract
Subject headings
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- Relapse is the main reason for treatment failure in childhood acute lymphoblastic leukemia. Despite improvements in the up-front therapy, survival after relapse is still relatively poor, especially for high-risk relapses. The aims of this study were to assess outcomes following acute lymphoblastic leukemia relapse after common initial Nordic Society of Paediatric Haematology and Oncology protocol treatment; to validate currently used risk stratifications, and identify additional prognostic factors for overall survival. Altogether, 516 of 2735 patients (18.9%) relapsed between 1992 and 2011 and were included in the study. There were no statistically significant differences in outcome between the up-front protocols or between the relapse protocols used, but an improvement over time was observed. The 5-year overall survival for patients relapsing in the period 2002-2011 was 57.5 +/- 3.4%, but 44.7 +/- 3.2% (P<0.001) if relapse occurred in the period 1992-2001. Factors independently predicting mortality after relapse included short duration of first remission, bone marrow involvement, age ten years or over, unfavorable cytogenetics, and Down syndrome. T-cell immunophenotype was not an independent prognostic factor unless in combination with hyperleukocytosis at diagnosis. The outcome for early combined pre-B relapses was unexpectedly poor (5-year overall survival 38.0 +/- 10.6%), which supports the notion that these patients need further risk adjustment. Although survival outcomes have improved over time, the development of novel approaches is urgently needed to increase survival in relapsed childhood acute lymphoblastic leukemia.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
Keyword
- leukemia
- treatment outcome
- scandinavian and nordic countries
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Oskarsson, Traus ...
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Soderhall, Stefa ...
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Arvidson, Johan, ...
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Forestier, Erik
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Montgomery, Scot ...
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Bottai, Matteo
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Lausen, Birgitte
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Carlsen, Niels
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Hellebostad, Mar ...
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Lahteenmaki, Pai ...
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Saarinen-Pihkala ...
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Jonsson, Olafur ...
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Heyman, Mats
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
- Articles in the publication
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Haematologica
- By the university
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Umeå University
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Örebro University
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Uppsala University
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Karolinska Institutet