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Meta-Analysis
. 2013 Feb;60(2):185-95.
doi: 10.1002/pbc.24228. Epub 2012 Jun 12.

Systematic review and meta-analysis of randomized trials of central nervous system directed therapy for childhood acute lymphoblastic leukemia

Sue Richards  1 , Ching-Hon Pui, Paul Gayon; Childhood Acute Lymphoblastic Leukemia Collaborative Group (CALLCG)
Collaborators, Affiliations
Meta-Analysis

Systematic review and meta-analysis of randomized trials of central nervous system directed therapy for childhood acute lymphoblastic leukemia

Sue Richards et al. Pediatr Blood Cancer. 2013 Feb.

Erratum in

  • Pediatr Blood Cancer. 2013 Oct;60(10):1729. Attarbarschi, A [corrected to Attarbaschi, A]; Escheriche, G [corrected to Escherich, G]

Abstract

Treatment of the central nervous system (CNS) is an essential therapy component for childhood acute lymphoblastic leukemia (ALL). Individual patient data from 47 trials addressing 16 CNS treatment comparisons were analyzed. Event-free survival (EFS) was similar for radiotherapy versus intrathecal (IT), and radiotherapy plus IT versus IV methotrexate (IV MTX) plus IT. Triple intrathecal therapy (TIT) gave similar EFS but poorer survival than intrathecal methotrexate (IT MTX), but additional IV MTX improved both outcomes. One trial resulted in similar EFS and survival with IV MTX plus IT MTX versus TIT alone. Radiotherapy can generally be replaced by IT therapy. TIT should be used with effective systemic therapy such as IV MTX.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

All members of the writing committee declare there are no conflicts of interest.

Figures

Figure 1
Figure 1
Effects of treatments on event free survival. Ratios of annual event rates with each trial result represented by a square, with larger squares indicating more information, and the overall result for each comparison represented by a diamond.
Figure 2
Figure 2
Descriptive event free and overall survival curves for TIT versus IT therapy.
Figure 3
Figure 3
Descriptive event free and overall survival curves for the addition of IV methotrexate to TIT.
Figure 4
Figure 4
Descriptive event free and overall survival curves for the addition of IV methotrexate to IT therapy.
See this image and copyright information in PMC

References

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