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Clinical Trial
. 2010 Feb;24(2):355-70.
doi: 10.1038/leu.2009.261. Epub 2009 Dec 17.

Long-term results of the pediatric oncology group studies for childhood acute lymphoblastic leukemia 1984-2001: a report from the children's oncology group

W L Salzer  1 , M Devidas, W L Carroll, N Winick, J Pullen, S P Hunger, B A Camitta
Affiliations
Clinical Trial

Long-term results of the pediatric oncology group studies for childhood acute lymphoblastic leukemia 1984-2001: a report from the children's oncology group

W L Salzer et al. Leukemia. 2010 Feb.

Abstract

From 1984 to 2001, the Pediatric Oncology Group (POG) conducted 12 acute lymphoblastic leukemia (ALL) studies. Ten-year event-free survival (EFS) for patients >12 months of age with B-precursor ALL on acute leukemia in children 14, 15 and 16 series were 66.7+/-1.2%, 68.1+/-1.4% and 73.2+/-2.1%, respectively. Intermediate dose methotrexate (ID MTX; 1 g/m(2)) improved outcomes for standard risk patients (10-year EFS 77.5+/-2.7% vs 66.3+/-3.1% for oral MTX). Neither MTX intensification (2.5 g/m(2)) nor addition of cytosine arabinoside/daunomycin/teniposide improved outcomes for higher risk patients. Intermediate dose mercaptopurine (1 g/m(2)) failed to improve outcomes for either group. Ten-year EFS for patients with T-cell ALL, POG 8704 and 9404 were 49.1+/-3.1% and 72.2+/-4.7%, respectively. Intensive asparaginase (10-year EFS 61.8 vs 42.7%) and high-dose MTX (5 g/m(2)) (10-year EFS 78.0 vs 65.8%) improved outcomes. There was a non-significant improvement in EFS for infants (10-year EFS 17.7+/-7.2-31.9+/-8.3%). Prognostic indicators for B-precursor ALL were age and WBC at diagnosis, gender, central nervous system disease, DNA index and cytogenetic abnormalities. Only gender was prognostic in T-cell ALL. In infants, WBC and MLL translocation were linked to inferior outcome.

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Figures

Figure 1
Figure 1
B-Precursor ALL (A) Event-Free Survival by Era, (B) Overall Survival by Era, (C) ALinC 14: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (D) ALinC 15: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (E) ALinC 16: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
Figure 1
Figure 1
B-Precursor ALL (A) Event-Free Survival by Era, (B) Overall Survival by Era, (C) ALinC 14: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (D) ALinC 15: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (E) ALinC 16: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
Figure 1
Figure 1
B-Precursor ALL (A) Event-Free Survival by Era, (B) Overall Survival by Era, (C) ALinC 14: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (D) ALinC 15: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (E) ALinC 16: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
Figure 1
Figure 1
B-Precursor ALL (A) Event-Free Survival by Era, (B) Overall Survival by Era, (C) ALinC 14: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (D) ALinC 15: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (E) ALinC 16: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
Figure 1
Figure 1
B-Precursor ALL (A) Event-Free Survival by Era, (B) Overall Survival by Era, (C) ALinC 14: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (D) ALinC 15: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (E) ALinC 16: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
Figure 2
Figure 2
T-Cell ALL (A) Event-Free Survival by Study, (B) Overall Survival by Study, (C) POG 8704: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (D) POG 9404: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
Figure 2
Figure 2
T-Cell ALL (A) Event-Free Survival by Study, (B) Overall Survival by Study, (C) POG 8704: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (D) POG 9404: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
Figure 2
Figure 2
T-Cell ALL (A) Event-Free Survival by Study, (B) Overall Survival by Study, (C) POG 8704: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (D) POG 9404: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
Figure 2
Figure 2
T-Cell ALL (A) Event-Free Survival by Study, (B) Overall Survival by Study, (C) POG 8704: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death, (D) POG 9404: Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
Figure 3
Figure 3
Infant ALL (A) EFS and Overall Survival, (B) Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
Figure 3
Figure 3
Infant ALL (A) EFS and Overall Survival, (B) Cumulative Incidence Rates of all CNS relapse, isolated CNS relapse, SMN, and death
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