Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000
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Open Access
- 10 December 2009
- journal article
- clinical trial
- Published by Springer Science and Business Media LLC in Leukemia
- Vol. 24 (2), 265-284
- https://doi.org/10.1038/leu.2009.257
Abstract
Between 1981 and 2000, 6609 children (<18 years of age) were treated in five consecutive trials of the Berlin–Frankfurt–Münster (BFM) study group for childhood acute lymphoblastic leukemia (ALL). Patients were treated in up to 82 centers in Germany, Austria and Switzerland. Probability of 10-year event-free survival (EFS) (survival) improved from 65% (77%) in study ALL-BFM 81 to 78% (85%) in ALL-BFM 95. In parallel to relapse reduction, major efforts focused on reducing acute and late toxicity through advanced risk adaptation of treatment. The major findings derived from these ALL-BFM trials were as follows: (1) preventive cranial radiotherapy could be safely reduced to 12 Gy in T-ALL and high-risk (HR) ALL patients, and eliminated in non- HR non-T-ALL patients, if it was replaced by high-dose and intrathecal (IT) MTX; (2) omission of delayed re-intensification severely impaired outcome of low-risk patients; (3) 6-month-less maintenance therapy caused an increase in systemic relapses; (4) slow response to an initial 7-day prednisone window was identified as adverse prognostic factor; (5) condensed induction therapy resulted in significant improvement of outcome; (6) the daunorubicin dose in induction could be safely reduced in low-risk patients and (7) intensification of consolidation/re-intensification treatment led to considerable improvement of outcome in HR patients.Keywords
This publication has 65 references indexed in Scilit:
- Thiopurine methyltransferase genetics is not a major risk factor for secondary malignant neoplasms after treatment of childhood acute lymphoblastic leukemia on Berlin-Frankfurt-Münster protocolsBlood, 2009
- Treating Childhood Acute Lymphoblastic Leukemia without Cranial IrradiationThe New England Journal of Medicine, 2009
- Methotrexate/6-mercaptopurine maintenance therapy influences the risk of a second malignant neoplasm after childhood acute lymphoblastic leukemia: results from the NOPHO ALL-92 studyBlood, 2009
- The Childhood Cancer Survivor Study: A National Cancer Institute–Supported Resource for Outcome and Intervention ResearchJournal of Clinical Oncology, 2009
- Genome-wide Interrogation of Germline Genetic Variation Associated With Treatment Response in Childhood Acute Lymphoblastic LeukemiaJAMA, 2009
- Factors influencing survival after relapse from acute lymphoblastic leukemia: a Children's Oncology Group studyLeukemia, 2008
- Cumulative Incidence of Secondary Neoplasms as a First Event After Childhood Acute Lymphoblastic LeukemiaJAMA, 2007
- Gene expression shift towards normal B cells, decreased proliferative capacity and distinct surface receptors characterize leukemic blasts persisting during induction therapy in childhood acute lymphoblastic leukemiaLeukemia, 2007
- Monitoring of asparaginase activity and asparagine levels in children on different asparaginase preparationsEuropean Journal of Cancer, 1996
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958