Long-term results of the risk-adapted treatment for childhood B-cell acute lymphoblastic leukemia: Report from the Japan association of childhood leukemia study ALL-97 trial

Keizo Horibe, Keiko Yumura-Yagi, Tooru Kudoh, Shinichiro Nishimura, Megumi Oda, Makoto Yoshida, Yoshihiro Komada, Junichi Hara, Akio Tawa, Ikuya Usami, Akihiko Tanizawa, Koji Kato, Ryoji Kobayashi, Keitaro Matsuo, Hiroki Hori

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9 Citations (Scopus)

Abstract

Purpose: This study was conducted as the first clinical trial by Japan Association of Childhood Leukemia Study to improve the outcome of B-cell acute lymphoblastic leukemia and explore a less toxic reinduction block. Patients and Methods: From 1997 to 2002, 563 patients with B-cell acute lymphoblastic leukemia aged 1 to 15 years were enrolled. The patients were assigned into 4 risk groups (standard, intermediate, high, or extremely high risk) and treated with regimens intensified according to the risk. Two randomized trials were conducted to compare 2 regimens with and without a 3-week reinduction therapy in the standard-risk group, and to compare the efficacy of pirarubicin with daunorubicin in the intermediate-risk and high-risk groups. Prophylactic cranial irradiation was restricted in patients with high or extremely high risk. Results: The event-free survival (EFS) rate at 10 years for all patients was 77.0%. Those in the standard-risk to extremely high-risk groups were 79.3%, 72.5%, 71.7%, and 66.3%, respectively. The 15-week induction/consolidation not followed by reinduction produced 76.4% of the EFS at 10 years comparable with the regimen with reinduction therapy. Pirarubicin at 25 mg/m 2 administered 11 times throughout the treatment produced the EFS comparable with daunorubicin at 30 mg/m 2. Conclusion: The trial produced high survival rates in NCI-HR patients, although the outcomes in NCI-SR patients were not satisfactory possibly due to less intensive central nervous system-directed therapy.

Original languageEnglish
Pages (from-to)81-89
Number of pages9
JournalJournal of Pediatric Hematology/Oncology
Volume39
Issue number2
DOIs
Publication statusPublished - 2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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