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Clinical Trial
. 2010 Feb;24(2):320-34.
doi: 10.1038/leu.2009.253. Epub 2009 Dec 17.

Long-term results of Dana-Farber Cancer Institute ALL Consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000)

L B Silverman  1 , K E Stevenson, J E O'Brien, B L Asselin, R D Barr, L Clavell, P D Cole, K M Kelly, C Laverdiere, B Michon, M A Schorin, C L Schwartz, E W O'Holleran, D S Neuberg, H J Cohen, S E Sallan
Affiliations
Clinical Trial

Long-term results of Dana-Farber Cancer Institute ALL Consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985-2000)

L B Silverman et al. Leukemia. 2010 Feb.

Abstract

The Dana-Farber Cancer Institute (DFCI) acute lymphoblastic leukemia (ALL) Consortium has been conducting multi-institutional clinical trials in childhood ALL since 1981. The treatment backbone has included 20-30 consecutive weeks of asparaginase during intensification and frequent vincristine/corticosteroid pulses during the continuation phase. Between 1985 and 2000, 1457 children aged 0-18 years were treated on four consecutive protocols: 85-01 (1985-1987), 87-01 (1987-1991), 91-01 (1991-1955) and 95-01 (1996-2000). The 10-year event-free survival (EFS)+/-s.e. by protocol was 77.9+/-2.8% (85-01), 74.2+/-2.3% (87-01), 80.8+/-2.1% (91-01) and 80.5+/-1.8% (95-01). Approximately 82% of patients treated in the 1980s and 88% treated in the 1990s were long-term survivors. Both EFS and overall survival (OS) rates were significantly higher for patients treated in the 1990s compared with the 1980s (P=0.05 and 0.01, respectively). On the two protocols conducted in the 1990s, EFS was 79-85% for T-cell ALL patients and 75-78% for adolescents (age 10-18 years). Results of randomized studies revealed that dexrazoxane prevented acute cardiac injury without adversely affecting EFS or OS in high-risk (HR) patients, and frequently dosed intrathecal chemotherapy was an effective substitute for cranial radiation in standard-risk (SR) patients. Current studies continue to focus on improving efficacy while minimizing acute and late toxicities.

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Conflict of interest statement

Conflicts of Interest: Dr. Silverman received compensation as an advisory board member for EUSA Pharma, and also received compensation as a consultant for Enzon, Inc. Dr. Sallan received honoraria and research funding from Enzon Inc. and compensation as an advisory board member for EUSA Pharma. Jane O’Brien, Kristen Stevenson, Eileen Whyte O’Holleran, and Drs. Asselin, Barr, Clavell, Cohen, Cole, Kelly, Laverdiere, Michon, Neuberg, Schorin, and Schwartz declare no conflict of interest.

Figures

Figure 1
Figure 1
Event-Free Survival (EFS) by Decade. The EFS of protocols conducted in the 1990s (91-01 and 95-01) was superior to that of protocols conducted in the 1980s (85-01 and 87-01), p=0.05.
Figure 2
Figure 2
Overall Survival (OS) by Decade. The OS of protocols conducted in the 1990s (91-01 and 95-01) was superior to that of protocols conducted in the 1980s (85-01 and 87-01), p=0.01.
Figure 3
Figure 3
Event-free survival and Cumulative Incidence of isolated or any CNS relapse for 220 patients treated on Protocol 85-01 (1985–7). Median follow-up was 13.8 years.
Figure 4
Figure 4
Event-free survival and Cumulative Incidence of isolated or any CNS relapse for 369 patients treated on Protocol 87-01 (1987–91). Median follow-up was 13.3 years.
Figure 5
Figure 5
Event-free survival and Cumulative Incidence of isolated or any CNS relapse for 377 patients treated on Protocol 91-01 (1991–5). Median follow-up was 12.5 years.
Figure 6
Figure 6
Event-free survival and Cumulative Incidence of isolated or any CNS relapse for 491 patients treated on Protocol 95-01 (1996–2000). Median follow-up was 8.6 years.
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References

    1. Sallan SE, Cammita BM, Cassady JR, Nathan DG, Frei E., 3rd Intermittent combination chemotherapy with adriamycin for childhood acute lymphoblastic leukemia: clinical results. Blood. 1978;51(3):425–433. - PubMed
    1. Sallan SE, Hitchcock-Bryan S, Gelber R, Cassady JR, Frei E, 3rd, Nathan DG. Influence of intensive asparaginase in the treatment of childhood non-T- cell acute lymphoblastic leukemia. Cancer Res. 1983;43(11):5601–5607. - PubMed
    1. Clavell LA, Gelber RD, Cohen HJ, Hitchcock-Bryan S, Cassady JR, Tarbell NJ, et al. Four-agent induction and intensive asparaginase therapy for treatment of childhood acute lymphoblastic leukemia. N Engl J Med. 1986;315(11):657–663. - PubMed
    1. Schorin MA, Blattner S, Gelber RD, Tarbell NJ, Donnelly M, Dalton V, et al. Treatment of childhood acute lymphoblastic leukemia: results of Dana- Farber Cancer Institute/Children's Hospital Acute Lymphoblastic Leukemia Consortium Protocol 85-01. J Clin Oncol. 1994;12(4):740–747. - PubMed
    1. LeClerc JM, Billett AL, Gelber RD, Dalton V, Tarbell N, Lipton JM, et al. Treatment of childhood acute lymphoblastic leukemia: results of Dana- Farber ALL Consortium Protocol 87-01. J Clin Oncol. 2002;20(1):237–246. - PubMed

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