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Temporal changes in...
Temporal changes in incidence of relapse and outcome after relapse of childhood acute lymphoblastic leukemia over three decades : a Nordic population-based cohort study
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- Jensen, Karen Schow (author)
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
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- Oskarsson, Trausti (author)
- Karolinska Institutet
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- Lähteenmäki, Päivi M. (author)
- Karolinska Institutet
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- Flaegstad, Trond (author)
- Department of Pediatrics, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway
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- Jónsson, Ólafur Gísli (author)
- Children’s Hospital, Landspitali University Hospital, Reykjavik, Iceland
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- Svenberg, Petter (author)
- Karolinska Institutet
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- Schmiegelow, Kjeld (author)
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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- Heyman, Mats (author)
- Karolinska Institutet
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- Norén-Nyström, Ulrika (author)
- Umeå universitet,Pediatrik
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- Schrøder, Henrik (author)
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
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- Albertsen, Birgitte Klug (author)
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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(creator_code:org_t)
- 2022-03-21
- 2022
- English.
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In: Leukemia. - : Springer Nature. - 0887-6924 .- 1476-5551. ; 36, s. 1274-1282
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Relapse remains the main obstacle to curing childhood acute lymphoblastic leukemia (ALL). The aims of this study were to compare incidence of relapse, prognostic factors, and survival after relapse between three consecutive Nordic Society of Pediatric Hematology and Oncology trials. Relapse occurred as a primary event in 638 of 4 458 children (1.0–14.9 years) diagnosed with Ph-negative ALL between 1992 and 2018. The 5-year cumulative incidence of relapse was 17.3% (95% CI 15.4–19.2%) and 16.5% (95% CI 14.3–18.8%) for patients in the ALL1992 and ALL2000 trials, respectively, but decreased to 8.4% (95% CI 7.0–10.1%) for patients in the ALL2008 trial. No changes in duration of first complete remission and site of relapse were observed over time; however, high hyperdiploidy, and t(12;21) decreased in the ALL2008 trial. The 4-year overall survival after relapse was 56.6% (95% CI 52.5–60.5%) and no statistically significant temporal improvements were observed. Age ≥10 years, T-cell immunophenotype, bone-marrow involvement, early and very early relapse, hypodiploidy, and Down syndrome all independently predicted worse outcome after relapse. Improvements in the primary treatment of childhood ALL has resulted in fewer relapses. However, failure to improve outcome of remaining relapses suggests a selection of harder-to-cure relapses and calls for new therapeutic strategies.
Subject headings
- 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 -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Keyword
- Oncology
- onkologi
- pediatrik
- Pediatrics
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- ref (subject category)
- art (subject category)
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Jensen, Karen Sc ...
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Oskarsson, Traus ...
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Lähteenmäki, Päi ...
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Flaegstad, Trond
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Jónsson, Ólafur ...
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Svenberg, Petter
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Schmiegelow, Kje ...
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Heyman, Mats
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Norén-Nyström, U ...
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Schrøder, Henrik
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Albertsen, Birgi ...
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- MEDICAL AND HEALTH SCIENCES
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Leukemia
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Umeå University
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Karolinska Institutet