Long-term follow-up of the United Kingdom Medical Research Council protocols for childhood acute lymphoblastic leukaemia, 1980-1997. Medical Research Council Childhood Leukaemia Working Party.

2.50
Hdl Handle:
http://hdl.handle.net/10541/86368
Title:
Long-term follow-up of the United Kingdom Medical Research Council protocols for childhood acute lymphoblastic leukaemia, 1980-1997. Medical Research Council Childhood Leukaemia Working Party.
Authors:
Eden, Tim O B; Harrison, G; Richards, S; Lilleyman, J S; Bailey, C C; Chessells, J M; Hann, I M; Hill, Frank G H; Gibson, B E
Abstract:
Results of three consecutive completed UK trials (1980-1997) for childhood lymphoblastic leukaemia are presented. National accrual has progressively increased so that over 90% of all the country's ALL cases were treated on the latest trial reported, UKALLXI. From 1980 to 1990, event-free and overall survival progressively improved, following adoption of an American therapy template and use of two post-remission intensification modules. Since 1990 despite demonstration of the benefit of a third intensification module overall event-free survival (EFS) has not improved further. Survival remains high due to a good retrieval rate especially for those relapsing off treatment after receipt of two intensification pulses. Possible reasons for the plateau in event-free survival (including type and dose of induction steroid, dropping of induction anthracycline, type and dose of asparaginase, gaps early in therapy following intensification, and overall lack of compliance in maintenance) are being explored in the latest protocol ALL '97. Cranial irradiation had been successfully replaced by a long course of intrathecal methotrexate injections for the majority of patients. Age (<1 year >10 years) sex (male) and white count >50 x 10(9)/l plus slow initial bone marrow clearance were consistently the most important independent prognostic indicators during this time period. Rome/NCI criteria accurately predict standard and high-risk groups for B cell lineage, but not consistently for T cell disease. This international collaborative venture might help us to define those truly at highest risk, and how we can optimise therapy for specific subgroups including T-ALL and those with unfavourable cytogenetics.
Affiliation:
Academic Unit of Paediatric Oncology, Christie and Royal Manchester Children's Hospital NHS Trusts, Oxford, UK.
Citation:
Long-term follow-up of the United Kingdom Medical Research Council protocols for childhood acute lymphoblastic leukaemia, 1980-1997. Medical Research Council Childhood Leukaemia Working Party. 2000, 14 (12):2307-20 Leukemia
Journal:
Leukemia
Issue Date:
Dec-2000
URI:
http://hdl.handle.net/10541/86368
PubMed ID:
11187922
Type:
Article
Language:
en
ISSN:
0887-6924
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorEden, Tim O Ben
dc.contributor.authorHarrison, Gen
dc.contributor.authorRichards, Sen
dc.contributor.authorLilleyman, J Sen
dc.contributor.authorBailey, C Cen
dc.contributor.authorChessells, J Men
dc.contributor.authorHann, I Men
dc.contributor.authorHill, Frank G Hen
dc.contributor.authorGibson, B Een
dc.date.accessioned2009-11-18T11:33:11Z-
dc.date.available2009-11-18T11:33:11Z-
dc.date.issued2000-12-
dc.identifier.citationLong-term follow-up of the United Kingdom Medical Research Council protocols for childhood acute lymphoblastic leukaemia, 1980-1997. Medical Research Council Childhood Leukaemia Working Party. 2000, 14 (12):2307-20 Leukemiaen
dc.identifier.issn0887-6924-
dc.identifier.pmid11187922-
dc.identifier.urihttp://hdl.handle.net/10541/86368-
dc.description.abstractResults of three consecutive completed UK trials (1980-1997) for childhood lymphoblastic leukaemia are presented. National accrual has progressively increased so that over 90% of all the country's ALL cases were treated on the latest trial reported, UKALLXI. From 1980 to 1990, event-free and overall survival progressively improved, following adoption of an American therapy template and use of two post-remission intensification modules. Since 1990 despite demonstration of the benefit of a third intensification module overall event-free survival (EFS) has not improved further. Survival remains high due to a good retrieval rate especially for those relapsing off treatment after receipt of two intensification pulses. Possible reasons for the plateau in event-free survival (including type and dose of induction steroid, dropping of induction anthracycline, type and dose of asparaginase, gaps early in therapy following intensification, and overall lack of compliance in maintenance) are being explored in the latest protocol ALL '97. Cranial irradiation had been successfully replaced by a long course of intrathecal methotrexate injections for the majority of patients. Age (<1 year >10 years) sex (male) and white count >50 x 10(9)/l plus slow initial bone marrow clearance were consistently the most important independent prognostic indicators during this time period. Rome/NCI criteria accurately predict standard and high-risk groups for B cell lineage, but not consistently for T cell disease. This international collaborative venture might help us to define those truly at highest risk, and how we can optimise therapy for specific subgroups including T-ALL and those with unfavourable cytogenetics.en
dc.language.isoenen
dc.subjectPrecursor Cell Lymphoblastic Leukaemia-Lymphoma-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshChild-
dc.subject.meshChild, Preschool-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInfant-
dc.subject.meshMale-
dc.subject.meshPrecursor Cell Lymphoblastic Leukemia-Lymphoma-
dc.subject.meshPrognosis-
dc.subject.meshSurvival Analysis-
dc.titleLong-term follow-up of the United Kingdom Medical Research Council protocols for childhood acute lymphoblastic leukaemia, 1980-1997. Medical Research Council Childhood Leukaemia Working Party.en
dc.typeArticleen
dc.contributor.departmentAcademic Unit of Paediatric Oncology, Christie and Royal Manchester Children's Hospital NHS Trusts, Oxford, UK.en
dc.identifier.journalLeukemiaen

Related articles on PubMed

All Items in Christie are protected by copyright, with all rights reserved, unless otherwise indicated.