Outcome after first relapse in childhood acute lymphoblastic leukaemia - lessons from the United Kingdom R2 trial.
Moorman, Anthony V
Darbyshire, Phil J
Hann, Ian M
Eden, Tim O B
AffiliationCancer Research UK Children's Cancer Group, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
MetadataShow full item record
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.
CitationOutcome after first relapse in childhood acute lymphoblastic leukaemia - lessons from the United Kingdom R2 trial. 2005, 130 (1):67-75 Br. J. Haematol.
JournalBritish Journal of Haematology
- The long-term results of childhood acute lymphoblastic leukemia at two centers from Turkey: 15 years of experience with the ALL-BFM 95 protocol.
- Authors: Güneş AM, Oren H, Baytan B, Bengoa SY, Evim MS, Gözmen S, Tüfekçi O, Karapınar TH, Irken G
- Issue date: 2014 Oct
- The UK experience in treating relapsed childhood acute lymphoblastic leukaemia: a report on the medical research council UKALLR1 study.
- Authors: Lawson SE, Harrison G, Richards S, Oakhill A, Stevens R, Eden OB, Darbyshire PJ
- Issue date: 2000 Mar
- Extended intrathecal methotrexate may replace cranial irradiation for prevention of CNS relapse in children with intermediate-risk acute lymphoblastic leukemia treated with Berlin-Frankfurt-Münster-based intensive chemotherapy. The Associazione Italiana di Ematologia ed Oncologia Pediatrica.
- Authors: Conter V, Aricò M, Valsecchi MG, Rizzari C, Testi AM, Messina C, Mori PG, Miniero R, Colella R, Basso G
- Issue date: 1995 Oct
- Long-term outcome in children with relapsed ALL by risk-stratified salvage therapy: results of trial acute lymphoblastic leukemia-relapse study of the Berlin-Frankfurt-Münster Group 87.
- Authors: Einsiedel HG, von Stackelberg A, Hartmann R, Fengler R, Schrappe M, Janka-Schaub G, Mann G, Hählen K, Göbel U, Klingebiel T, Ludwig WD, Henze G
- Issue date: 2005 Nov 1
- Treatment of childhood acute lymphoblastic leukemia. Long-term results of the AIEOP-ALL 87 study.
- Authors: Paolucci G, Vecchi V, Favre C, Miniero R, Madon E, Pession A, Rondelli R, De Rossi G, Lo Nigro L, Porta F, Santoro N, Indolfi P, Basso G, Conter V, Aricò M, Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP).
- Issue date: 2001 May