JACLS ALL-02 SR protocol reduced-intensity chemotherapy produces excellent outcomes in patients with low-risk childhood acute lymphoblastic leukemia

Yoshihiro Takahashi, Hisashi Ishida, Toshihiko Imamura, Kosuke Tamefusa, Souichi Suenobu, Ikuya Usami, Keiko Yumura-Yagi, Daiichiro Hasegawa, Shinichiro Nishimura, Nobuhiro Suzuki, Yoshiko Hashii, Takao Deguchi, Akiko Moriya-Saito, Yoshiyuki Kosaka, Koji Kato, Ryoji Kobayashi, Hirohide Kawasaki, Hiroki Hori, Atsushi Sato, Toru KudoTatsutoshi Nakahata, Megumi Oda, Junichi Hara, Keizo Horibe

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. As overall cure rates of childhood ALL have improved, reduction of overall treatment intensity while still ensuring excellent outcomes is imperative for low-risk patients. We report the outcomes of patients treated following the standard-risk protocol from the prospective Japan Association of Childhood Leukemia Study (JACLS) ALL-02 study, which was conducted between 2002 and 2008 for patients with newly diagnosed ALL aged 1–18 years. Of 1138 patients with B-cell precursor ALL, 388 (34.1%) were allocated to this protocol. Excellent outcomes were achieved despite the overall treatment intensity being lower than that of most contemporary protocols: 4 years event-free survival (EFS) was 92.3% and 4 years overall survival 98.2%. Patients with high hyperdiploidy (HHD) involving triple trisomy (trisomy of chromosomes 4, 10, and 17) or ETV6-RUNX1 had even better outcomes (4 years EFS 97.6% and 100%, respectively). Unique characteristics of this protocol include a selection of low-risk patients with a low initial WBC count and good early treatment response and reduction of cumulative doses of chemotherapeutic agents while maintaining dose density. In Japan, we are currently investigating the feasibility of this protocol while incorporating minimal residual disease into the patient stratification strategy.

Original languageEnglish
Pages (from-to)890-897
Number of pages8
JournalInternational journal of hematology
Volume115
Issue number6
DOIs
Publication statusPublished - Jun 2022
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology

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