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Outcome of children...
Outcome of children with high-risk acute lymphoblastic leukemia (HR-ALL): Nordic results on an intensive regimen with restricted central nervous system irradiation
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Saarinen-Pihkala, U. M. (author)
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Gustafsson, G. (author)
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Carlsen, N. (author)
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Flaegstad, T. (author)
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Forestier, E. (author)
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Glomstein, A. (author)
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Kristinsson, J. (author)
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Lanning, M. (author)
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Schroeder, H. (author)
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- Mellander, Lotta, 1941 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kvinnors och barns hälsa, Avdelningen för pediatrik,Institute for the Health of Women and Children, Dept of Paediatrics
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(creator_code:org_t)
- 2004
- 2004
- English.
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In: Pediatr Blood Cancer. - 1545-5009. ; 42:1, s. 8-23
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https://gup.ub.gu.se...
Abstract
Subject headings
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- BACKGROUND: Improvement in outcome of childhood high-risk (HR) ALL was sought with a very intensive Nordic protocol leaving most patients without CNS-RT. METHODS: A total of 426 consecutive children entered the NOPHO-92 HR-ALL program. HR criteria included WBC > or =50 x 10(9)/L, CNS or testicular involvement, T-cell, lymphomatous features, t(9;22), t(4;11), or slow response. Of these, 152 children had very high risk (VHR) with special definitions. CNS consolidation was based on high-dose MTX (8 g/m2) and ARA-C (12 g/m2) alternating. VHR patients also received cranial RT. RESULTS: The 9-year EFS was 61 +/- 3%, OS 74 +/- 2%, and EFS for T-ALL 62 +/- 4%. Cumulative incidence of isolated CNS relapse was 4.7 +/- 1%, and CNS relapse in total 9.9 +/- 2%. Poor prognostic factors were WBC > or =200 x 10(9)/L and a very slow response. CONCLUSIONS: HR-ALL was successfully treated on the NOPHO-92 regimen, with a relatively low CNS relapse rate for non-irradiated children. WBC > or =200 x 10(9)/L and very slow response emerged as strong poor prognostic factors.
Keyword
- Adolescent
- dosage/*therapeutic use
- Central Nervous System Neoplasms/*therapy
- Child
- Child
- Preschool
- Cohort Studies
- Combined Modality Therapy
- *Cranial Irradiation
- Cytarabine/administration & dosage
- Disease-Free Survival
- Female
- Humans
- Infant
- Leukemia
- Lymphocytic
- Acute/*therapy
- Male
- Methotrexate/administration & dosage
- Risk Factors
- Stem Cell Transplantation
- Transplantation
- Homologous
- Treatment Outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
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