Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000
Anja Möricke,M Zimmermann,A. Reiter,Günter Henze,André Schrauder,Helmut Gadner,W.-D. Ludwig,J. Ritter,Jochen Harbott,Georg Mann,T. Klingebiel,Felix Zintl,Charlotte M. Niemeyer,Bernhard Kremens,Felix Niggli,Dietrich Niethammer,Karl Welte,Martin Stanulla,E. Odenwald,Hansjörg Riehm,Martin Schrappe +20 more
TLDR
The major findings derived from these ALL-BFM trials were that preventive cranial radiotherapy could be safely reduced to 12 Gy in T-ALL and high-risk (HR) ALL patients, and eliminated in non- HR non-T-ALL patients, if it was replaced by high-dose and intrathecal (IT) MTX.Abstract:
Between 1981 and 2000, 6609 children (<18 years of age) were treated in five consecutive trials of the Berlin-Frankfurt-Munster (BFM) study group for childhood acute lymphoblastic leukemia (ALL) Patients were treated in up to 82 centers in Germany, Austria and Switzerland Probability of 10-year event-free survival (EFS) (survival) improved from 65% (77%) in study ALL-BFM 81 to 78% (85%) in ALL-BFM 95 In parallel to relapse reduction, major efforts focused on reducing acute and late toxicity through advanced risk adaptation of treatment The major findings derived from these ALL-BFM trials were as follows: (1) preventive cranial radiotherapy could be safely reduced to 12 Gy in T-ALL and high-risk (HR) ALL patients, and eliminated in non- HR non-T-ALL patients, if it was replaced by high-dose and intrathecal (IT) MTX; (2) omission of delayed re-intensification severely impaired outcome of low-risk patients; (3) 6-month-less maintenance therapy caused an increase in systemic relapses; (4) slow response to an initial 7-day prednisone window was identified as adverse prognostic factor; (5) condensed induction therapy resulted in significant improvement of outcome; (6) the daunorubicin dose in induction could be safely reduced in low-risk patients and (7) intensification of consolidation/re-intensification treatment led to considerable improvement of outcome in HR patientsread more
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Journal ArticleDOI
Improved Survival for Children and Adolescents With Acute Lymphoblastic Leukemia Between 1990 and 2005: A Report From the Children's Oncology Group
Stephen P. Hunger,Xiaomin Lu,Meenakshi Devidas,Bruce M. Camitta,Paul S. Gaynon,Naomi J. Winick,Gregory H. Reaman,Gregory H. Reaman,William L. Carroll +8 more
TL;DR: This study documents ongoing survival improvements for children and adolescents with acute lymphoblastic leukemia, emphasizing that efforts to further improve survival must be directed at both high-risk subsets and at those children predicted to have an excellent chance for cure.
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Biology, Risk Stratification, and Therapy of Pediatric Acute Leukemias: An Update
TL;DR: The application of new high-throughput sequencing techniques to define the complete DNA sequence of leukemia and host normal cells and the development of new agents targeted to leukemogenic pathways promise to further improve outcome in the coming decade.
Journal ArticleDOI
Childhood Acute Lymphoblastic Leukemia: Progress Through Collaboration
Ching-Hon Pui,Jun J. Yang,Stephen P. Hunger,Rob Pieters,Martin Schrappe,Andrea Biondi,Ajay Vora,André Baruchel,Lewis B. Silverman,Kjeld Schmiegelow,Gabriele Escherich,Keizo Horibe,Yves Benoit,Shai Izraeli,Allen Eng Juh Yeoh,Der Cherng Liang,James R. Downing,William E. Evans,Mary V. Relling,Charles G. Mullighan +19 more
TL;DR: The information gained from collaborative studies has helped decipher the heterogeneity of ALL to help improve personalized treatment, which will further advance the current high cure rate and the quality of life for children and adolescents with ALL.
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Pediatric acute lymphoblastic leukemia: where are we going and how do we get there?
Ching-Hon Pui,Charles G. Mullighan,William E. Evans,William E. Evans,Mary V. Relling,Mary V. Relling +5 more
TL;DR: Specific areas of research are discussed that promise to further refine current treatment and to improve the cure rate and quality of life of the patients.
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Phase I/Phase II Study of Blinatumomab in Pediatric Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia
Arend von Stackelberg,Franco Locatelli,Gerhard Zugmaier,Rupert Handgretinger,Tanya M. Trippett,Carmelo Rizzari,Peter Bader,Maureen M. O'Brien,Benoit Brethon,Deepa Bhojwani,Paul G. Schlegel,Arndt Borkhardt,Susan R. Rheingold,Todd M. Cooper,Christian M. Zwaan,Phillip Barnette,Chiara Messina,Gérard Michel,Steven G. DuBois,Kuolung Hu,Min Zhu,James A. Whitlock,Lia Gore +22 more
TL;DR: This trial, which to the best of the authors' knowledge was the first such trial in pediatrics, demonstrated antileukemic activity of single-agent blinatumomab with complete minimal residual disease response in children with relapsed/refractory BCP-ALL.
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