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Clinical Trial
. 2010 Feb;24(2):406-18.
doi: 10.1038/leu.2009.256. Epub 2009 Dec 10.

Long-term follow-up of the United Kingdom medical research council protocols for childhood acute lymphoblastic leukaemia, 1980-2001

C Mitchell  1 , S Richards, C J Harrison, T Eden
Affiliations
Clinical Trial

Long-term follow-up of the United Kingdom medical research council protocols for childhood acute lymphoblastic leukaemia, 1980-2001

C Mitchell et al. Leukemia. 2010 Feb.

Abstract

Between 1980 and 2001, the United Kingdom Medical Research Council Childhood Leukemia Working Party conducted four clinical trials in acute lymphoblastic leukaemia (ALL), which recruited a total of 6516 patients. UKALL VIII examined the role of daunorubicin in induction chemotherapy, and UKALL X examined the role of post-induction intensification. Both resulted in major improvement in the outcomes. UKALL XI examined the efficacy of different methods of central nervous system-directed therapy and the effects of an additional intensification. ALL97, which was initially based on the UKALL XD template (two intensification phases), examined the role of different steroids in induction and of different thiopurines through continuing chemotherapy. A reappraisal of results from UKALL XI compared with other cooperative group results led to a redesign in 1999, which subsequently resulted in a major improvement in outcomes. In addition, ALL97 and ALL97/99 showed a significant advantage for the use of dexamethasone rather than prednisolone; although the use of 6-thioguanine resulted in fewer relapses, this advantage was offset by an increased incidence of deaths in remission. Over the era encompassed by these four trials, there has been a major improvement in both event-free and overall survival for children in the United Kingdom with ALL.

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Figures

Figure 1
Figure 1
Event free survival, MRC Childhood ALL trials, UKALL VIII – ALL97. The number of children at risk is indicated along the time axis.
Figure 2
Figure 2
Overall survival, MRC Childhood ALL trials, UKALL VIII – ALL97. The number of children at risk is indicated along the time axis.
Figure 3
Figure 3
Incidence of isolated CNS relapse, MRC Childhood ALL trials, UKALL VIII – ALL97. The number of children at risk is indicated along the time axis.
Figure 4
Figure 4
Incidence of any CNS relapse, MRC Childhood ALL trials, UKALL VIII – ALL97. The number of children at risk is indicated along the time axis.
Figure 5
Figure 5
Event free survival, ALL97 and 97/99, by phase of trial. The number of children at risk is indicated along the time axis.
Figure 6
Figure 6
Overall survival, ALL97 and 97/99, by phase of trial. The number of children at risk is indicated along the time axis.
See this image and copyright information in PMC

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References

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