Effective VCR/DEX pulse maintenance therapy in the KYCCSG ALL-02 protocol for pediatric acute lymphoblastic leukemia

Yasuhiro Okamoto, Yuki Koga, Jiro Inagaki, Shuichi Ozono, Koichiro Ueda, Maiko Shimoura, Nobuyoshi Itonaga, Yuichi Shinkoda, Hiroshi Moritake, Yuko Nomura, Hideki Nakayama, Noriko Hotta, Yasufumi Hidaka, Hidemi Shimonodan, Naohiro Suga, Takayuki Tanabe, Kentaro Nakashima, Reiji Fukano, Yoshifumi Kawano

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Abstract

In a previous study of childhood acute lymphoblastic leukemia (ALL) by the Kyushu–Yamaguchi Children’s Cancer Study Group, ALL-96, we achieved a 72.1 % 5-year event-free survival (EFS) and an 84.8 % 5-year overall survival (OS). In a subsequent study, ALL-02, we adopted a vincristine dexamethasone (VCR/DEX) pulse regimen as maintenance therapy in the context of the ALL-96 study using the same risk classification and treatment schedule. A total of 156 pediatric cases of ALL were treated with ALL-02. All of the patients were classified as standard-risk or high-risk. Risk stratification was based on white cell counts, immunophenotype, the presence of central nervous system (CNS) disease at diagnosis, organomegaly, and early treatment response (day 14 bone marrow status). The 7-year EFS and OS rates were 77.7 % (95 % CI 70.6–84.8 %) and 89.5 % (95 % CI 84.6–94.4 %), respectively. CNS 3 status [hazard ratio (HR) = 5.0, p = 0.009] and high white blood cell count at diagnosis (HR = 2.6, p = 0.047) were risk factors for poor EFS in multivariate analysis. Our strategies to categorize patients into two risk groups, and to treat with a VCR/DEX pulse were feasible and reasonably effective treatments for pediatric ALL.

Original languageEnglish
Pages (from-to)202-209
Number of pages8
JournalInternational journal of hematology
Volume103
Issue number2
DOIs
Publication statusPublished - Feb 1 2016

All Science Journal Classification (ASJC) codes

  • Hematology

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    Okamoto, Y., Koga, Y., Inagaki, J., Ozono, S., Ueda, K., Shimoura, M., Itonaga, N., Shinkoda, Y., Moritake, H., Nomura, Y., Nakayama, H., Hotta, N., Hidaka, Y., Shimonodan, H., Suga, N., Tanabe, T., Nakashima, K., Fukano, R., & Kawano, Y. (2016). Effective VCR/DEX pulse maintenance therapy in the KYCCSG ALL-02 protocol for pediatric acute lymphoblastic leukemia. International journal of hematology, 103(2), 202-209. https://doi.org/10.1007/s12185-015-1910-1