Outcome after first relapse in childhood acute lymphoblastic leukaemia - lessons from the United Kingdom R2 trial.

2.50
Hdl Handle:
http://hdl.handle.net/10541/74931
Title:
Outcome after first relapse in childhood acute lymphoblastic leukaemia - lessons from the United Kingdom R2 trial.
Authors:
Roy, Anindita; Cargill, Anna; Love, Sharon; Moorman, Anthony V; Stoneham, Sara; Lim, Anita; Darbyshire, Phil J; Lancaster, Donna; Hann, Ian M; Eden, Tim O B; Saha, Vaskar
Abstract:
A retrospective analysis of children with first relapse of acute lymphoblastic leukaemia (ALL), treated on the UKALL R2 protocol at four different hospitals, between June 1995 and December 2002 was performed. Of the 150 children 139 (93%) achieved a second complete remission. The overall survival (OS) and event-free survival (EFS) for the whole group was 56% and 47% respectively. The duration of first complete remission and immunophenotype, but not sites of relapse, were predictive for survival. Using the Berlin-Frankfürt-Münster risk stratification for relapsed ALL, the OS and EFS for standard, intermediate (IR) and high risk (HR) groups were 92% and 92%, 64% and 51%, and 14% and 15%, respectively; P < 0.0001 for both OS and EFS. In the IR group, those with a very early isolated central nervous system relapse also had a significantly worse outcome (P = 0.0001). Given the poor outcome of a second relapse, clear strategies are required to identify those in the IR group who will most benefit from stem cell transplantation (SCT). A higher proportion (16%) of induction failures in the HR group suggest the need for novel agents during this phase of treatment, but SCT was associated with a lower relapse rate and better outcome than those treated with chemotherapy alone.
Affiliation:
Cancer Research UK Children's Cancer Group, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Citation:
Outcome after first relapse in childhood acute lymphoblastic leukaemia - lessons from the United Kingdom R2 trial. 2005, 130 (1):67-75 Br. J. Haematol.
Journal:
British Journal of Haematology
Issue Date:
Jul-2005
URI:
http://hdl.handle.net/10541/74931
DOI:
10.1111/j.1365-2141.2005.05572.x
PubMed ID:
15982346
Type:
Article
Language:
en
ISSN:
0007-1048
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorRoy, Anindita-
dc.contributor.authorCargill, Anna-
dc.contributor.authorLove, Sharon-
dc.contributor.authorMoorman, Anthony V-
dc.contributor.authorStoneham, Sara-
dc.contributor.authorLim, Anita-
dc.contributor.authorDarbyshire, Phil J-
dc.contributor.authorLancaster, Donna-
dc.contributor.authorHann, Ian M-
dc.contributor.authorEden, Tim O B-
dc.contributor.authorSaha, Vaskar-
dc.date.accessioned2009-07-22T10:44:44Z-
dc.date.available2009-07-22T10:44:44Z-
dc.date.issued2005-07-
dc.identifier.citationOutcome after first relapse in childhood acute lymphoblastic leukaemia - lessons from the United Kingdom R2 trial. 2005, 130 (1):67-75 Br. J. Haematol.en
dc.identifier.issn0007-1048-
dc.identifier.pmid15982346-
dc.identifier.doi10.1111/j.1365-2141.2005.05572.x-
dc.identifier.urihttp://hdl.handle.net/10541/74931-
dc.description.abstractA retrospective analysis of children with first relapse of acute lymphoblastic leukaemia (ALL), treated on the UKALL R2 protocol at four different hospitals, between June 1995 and December 2002 was performed. Of the 150 children 139 (93%) achieved a second complete remission. The overall survival (OS) and event-free survival (EFS) for the whole group was 56% and 47% respectively. The duration of first complete remission and immunophenotype, but not sites of relapse, were predictive for survival. Using the Berlin-Frankfürt-Münster risk stratification for relapsed ALL, the OS and EFS for standard, intermediate (IR) and high risk (HR) groups were 92% and 92%, 64% and 51%, and 14% and 15%, respectively; P < 0.0001 for both OS and EFS. In the IR group, those with a very early isolated central nervous system relapse also had a significantly worse outcome (P = 0.0001). Given the poor outcome of a second relapse, clear strategies are required to identify those in the IR group who will most benefit from stem cell transplantation (SCT). A higher proportion (16%) of induction failures in the HR group suggest the need for novel agents during this phase of treatment, but SCT was associated with a lower relapse rate and better outcome than those treated with chemotherapy alone.en
dc.language.isoenen
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshAsparaginase-
dc.subject.meshBone Marrow Transplantation-
dc.subject.meshChild-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshDisease-Free Survival-
dc.subject.meshEpirubicin-
dc.subject.meshFemale-
dc.subject.meshGreat Britain-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphoma-
dc.subject.meshPrednisolone-
dc.subject.meshRecurrence-
dc.subject.meshRemission Induction-
dc.subject.meshRetrospective Studies-
dc.subject.meshRisk Factors-
dc.subject.meshSurvival Rate-
dc.subject.meshTreatment Outcome-
dc.subject.meshVincristine-
dc.titleOutcome after first relapse in childhood acute lymphoblastic leukaemia - lessons from the United Kingdom R2 trial.en
dc.typeArticleen
dc.contributor.departmentCancer Research UK Children's Cancer Group, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.en
dc.identifier.journalBritish Journal of Haematologyen

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