Long-term results of NOPHO ALL-92 and ALL-2000 studies of childhood acute lymphoblastic leukemia

2.50
Hdl Handle:
http://hdl.handle.net/2336/95893
Title:
Long-term results of NOPHO ALL-92 and ALL-2000 studies of childhood acute lymphoblastic leukemia
Authors:
Schmiegelow, K; Forestier, E; Hellebostad, M; Heyman, M; Kristinsson, J; Söderhäll, S; Taskinen, M
Citation:
Leukemia. 2010, 24(2):345-54
Issue Date:
1-Feb-2010
Abstract:
Analysis of 2668 children with acute lymphoblastic leukemia (ALL) treated in two successive Nordic clinical trials (Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL-92 and ALL-2000) showed that 75% of all patients are cured by first-line therapy, and 83% are long-term survivors. Improvements in systemic and intrathecal chemotherapy have reduced the use of central nervous system (CNS) irradiation to <10% of the patients and provided a 5-year risk of isolated CNS relapse of 2.6%. Improved risk stratification and chemotherapy have eliminated the previous independent prognostic significance of gender, CNS leukemia and translocation t(1;19)(q23;p13), whereas the post-induction level of minimal residual disease (MRD) has emerged as a new risk grouping feature. Infant leukemia, high leukocyte count, T-lineage immunophenotype, translocation t(4;11)(q21;q23) and hypodiploidy persist to be associated with lower cure rates. To reduce the overall toxicity of the treatment, including the risk of therapy-related second malignant neoplasms, the current NOPHO ALL-2008 protocol does not include CNS irradiation in first remission, the dose of 6-mercaptopurine is reduced for patients with low thiopurine methyltransferase activity, and the protocol restricts the use of hematopoietic stem cell transplantation in first remission to patients without morphological remission after induction therapy or with high levels of MRD after 3 months of therapy.
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/10.1038/leu.2009.251

Full metadata record

DC FieldValue Language
dc.contributor.authorSchmiegelow, Ken
dc.contributor.authorForestier, Een
dc.contributor.authorHellebostad, Men
dc.contributor.authorHeyman, Men
dc.contributor.authorKristinsson, Jen
dc.contributor.authorSöderhäll, Sen
dc.contributor.authorTaskinen, Men
dc.date.accessioned2010-04-07T12:43:39Z-
dc.date.available2010-04-07T12:43:39Z-
dc.date.issued2010-02-01-
dc.date.submitted2010-04-07-
dc.identifier.citationLeukemia. 2010, 24(2):345-54en
dc.identifier.issn1476-5551-
dc.identifier.pmid20010622-
dc.identifier.doi10.1038/leu.2009.251-
dc.identifier.urihttp://hdl.handle.net/2336/95893-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractAnalysis of 2668 children with acute lymphoblastic leukemia (ALL) treated in two successive Nordic clinical trials (Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL-92 and ALL-2000) showed that 75% of all patients are cured by first-line therapy, and 83% are long-term survivors. Improvements in systemic and intrathecal chemotherapy have reduced the use of central nervous system (CNS) irradiation to <10% of the patients and provided a 5-year risk of isolated CNS relapse of 2.6%. Improved risk stratification and chemotherapy have eliminated the previous independent prognostic significance of gender, CNS leukemia and translocation t(1;19)(q23;p13), whereas the post-induction level of minimal residual disease (MRD) has emerged as a new risk grouping feature. Infant leukemia, high leukocyte count, T-lineage immunophenotype, translocation t(4;11)(q21;q23) and hypodiploidy persist to be associated with lower cure rates. To reduce the overall toxicity of the treatment, including the risk of therapy-related second malignant neoplasms, the current NOPHO ALL-2008 protocol does not include CNS irradiation in first remission, the dose of 6-mercaptopurine is reduced for patients with low thiopurine methyltransferase activity, and the protocol restricts the use of hematopoietic stem cell transplantation in first remission to patients without morphological remission after induction therapy or with high levels of MRD after 3 months of therapy.en
dc.language.isoenen
dc.publisherNature Publishing Group, Specialist Journalsen
dc.relation.urlhttp://dx.doi.org/10.1038/leu.2009.251en
dc.subject.meshAdolescenten
dc.subject.meshAntineoplastic Combined Chemotherapy Protocolsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshChromosome Aberrationsen
dc.subject.meshCombined Modality Therapyen
dc.subject.meshCranial Irradiationen
dc.subject.meshFemaleen
dc.subject.meshFollow-Up Studiesen
dc.subject.meshHematopoietic Stem Cell Transplantationen
dc.subject.meshHumansen
dc.subject.meshImmunophenotypingen
dc.subject.meshInfanten
dc.subject.meshInfant, Newbornen
dc.subject.meshMaleen
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphomaen
dc.subject.meshPrognosisen
dc.subject.meshRemission Inductionen
dc.subject.meshRisk Factorsen
dc.subject.meshSurvival Rateen
dc.subject.meshTime Factorsen
dc.subject.meshTreatment Outcomeen
dc.titleLong-term results of NOPHO ALL-92 and ALL-2000 studies of childhood acute lymphoblastic leukemiaen
dc.typeArticleen
dc.contributor.departmentFaculty of Medicine, The Institute of Gynaecology, Obstetrics, and Paediatrics, University of Copenhagen, Copenhagen, Denmark. kschmiegelow@rh.dken
dc.identifier.journalLeukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.Ken

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