Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO)

2.50
Hdl Handle:
http://hdl.handle.net/2336/49001
Title:
Intensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO)
Authors:
Gustafsson, G; Kreuger, A; Clausen, N; Garwicz, S; Kristinsson, J; Lie, S O; Moe, P J; Perkkiö, M; Yssing, M; Saarinen-Pihkala, U M
Citation:
Acta Paediatr. 1998, 87(11):1151-61
Issue Date:
1-Nov-1998
Abstract:
In a multinational, population-based study from the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden), 2648 children below 15 y of age were diagnosed with acute lymphoblastic leukaemia (ALL) in the years 1981-1996. The annual incidence was 3.9/100000 children and was stable throughout the study period. The development from regional or national protocols to common Nordic treatment protocols for all risk groups was completed in 1992 through a successive intensification of therapy, based on multidrug chemotherapy including pulses of methotrexate in high doses and avoidance of cranial irradiation in most children. For children with non-B-cell ALL (n=2602), the event-free survival (p-EFS) increased from 0.53+/-0.02 (diagnosed 7/81-6/86) to 0.67+/-0.02 (7/86-12/91) to 0.78+/-0.02 (1/92-12/96). The corresponding p-EFS values at 5 y were 0.57, 0.70 and 0.78, respectively. The main improvements were seen in the group of children with non-high risk leukaemia, with 5-y p-EFS values increasing from 0.60 to 0.76 and 0.85 for the three periods. In high-risk patients, progress has been moderate, especially in children with high white blood cell values at diagnosis. During the last 5-y period, only 10% of the patients received cranial irradiation in first remission while 90% of the patients received high doses of cytostatic infusions (methotrexate isolated or combined with cytarabinoside) and multiple intrathecal injections of methotrexate as CNS-adjusted treatment without any indication of an increased CNS relapse rate.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://dx.doi.org/10.1111/j.1651-2227.1998.tb00923.x

Full metadata record

DC FieldValue Language
dc.contributor.authorGustafsson, G-
dc.contributor.authorKreuger, A-
dc.contributor.authorClausen, N-
dc.contributor.authorGarwicz, S-
dc.contributor.authorKristinsson, J-
dc.contributor.authorLie, S O-
dc.contributor.authorMoe, P J-
dc.contributor.authorPerkkiö, M-
dc.contributor.authorYssing, M-
dc.contributor.authorSaarinen-Pihkala, U M-
dc.date.accessioned2009-02-12T15:49:11Z-
dc.date.available2009-02-12T15:49:11Z-
dc.date.issued1998-11-01-
dc.date.submitted2009-02-12-
dc.identifier.citationActa Paediatr. 1998, 87(11):1151-61en
dc.identifier.issn0803-5253-
dc.identifier.pmid9846917-
dc.identifier.doi10.1111/j.1651-2227.1998.tb00923.x-
dc.identifier.urihttp://hdl.handle.net/2336/49001-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractIn a multinational, population-based study from the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden), 2648 children below 15 y of age were diagnosed with acute lymphoblastic leukaemia (ALL) in the years 1981-1996. The annual incidence was 3.9/100000 children and was stable throughout the study period. The development from regional or national protocols to common Nordic treatment protocols for all risk groups was completed in 1992 through a successive intensification of therapy, based on multidrug chemotherapy including pulses of methotrexate in high doses and avoidance of cranial irradiation in most children. For children with non-B-cell ALL (n=2602), the event-free survival (p-EFS) increased from 0.53+/-0.02 (diagnosed 7/81-6/86) to 0.67+/-0.02 (7/86-12/91) to 0.78+/-0.02 (1/92-12/96). The corresponding p-EFS values at 5 y were 0.57, 0.70 and 0.78, respectively. The main improvements were seen in the group of children with non-high risk leukaemia, with 5-y p-EFS values increasing from 0.60 to 0.76 and 0.85 for the three periods. In high-risk patients, progress has been moderate, especially in children with high white blood cell values at diagnosis. During the last 5-y period, only 10% of the patients received cranial irradiation in first remission while 90% of the patients received high doses of cytostatic infusions (methotrexate isolated or combined with cytarabinoside) and multiple intrathecal injections of methotrexate as CNS-adjusted treatment without any indication of an increased CNS relapse rate.en
dc.language.isoenen
dc.relation.urlhttp://dx.doi.org/10.1111/j.1651-2227.1998.tb00923.xen
dc.subject.meshAntineoplastic Combined Chemotherapy Protocolsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshClinical Protocolsen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshMaleen
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphomaen
dc.subject.meshProbabilityen
dc.subject.meshPrognosisen
dc.subject.meshRetrospective Studiesen
dc.subject.meshScandinaviaen
dc.subject.meshSurvival Analysisen
dc.subject.meshTreatment Outcomeen
dc.titleIntensified treatment of acute childhood lymphoblastic leukaemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996. Nordic Society of Paediatric Haematology and Oncology (NOPHO)en
dc.typeArticleen
dc.contributor.departmentChildhood Cancer Research Unit, Karolinska Hospital, Stockholm, Sweden.en
dc.identifier.journalActa paediatrica (Oslo, Norway : 1992)en

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