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

Research output: Contribution to journalArticle

6 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 - Jan 1 2017
Externally publishedYes

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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Japan
Leukemia
B-Lymphocytes
Disease-Free Survival
Daunorubicin
Therapeutics
Survival Rate
Cranial Irradiation
Poisons
Central Nervous System
Clinical Trials

All Science Journal Classification (ASJC) codes

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

Cite this

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

In: Journal of Pediatric Hematology/Oncology, Vol. 39, No. 2, 01.01.2017, p. 81-89.

Research output: Contribution to journalArticle

Horibe, K, Yumura-Yagi, K, Kudoh, T, Nishimura, S, Oda, M, Yoshida, M, Komada, Y, Hara, J, Tawa, A, Usami, I, Tanizawa, A, Kato, K, Kobayashi, R, Matsuo, K & Hori, H 2017, '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', Journal of Pediatric Hematology/Oncology, vol. 39, no. 2, pp. 81-89. https://doi.org/10.1097/MPH.0000000000000760
Horibe, Keizo ; Yumura-Yagi, Keiko ; Kudoh, Tooru ; Nishimura, Shinichiro ; Oda, Megumi ; Yoshida, Makoto ; Komada, Yoshihiro ; Hara, Junichi ; Tawa, Akio ; Usami, Ikuya ; Tanizawa, Akihiko ; Kato, Koji ; Kobayashi, Ryoji ; Matsuo, Keitaro ; Hori, Hiroki. / 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. In: Journal of Pediatric Hematology/Oncology. 2017 ; Vol. 39, No. 2. pp. 81-89.
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T2 - Report from the Japan association of childhood leukemia study ALL-97 trial

AU - Horibe, Keizo

AU - Yumura-Yagi, Keiko

AU - Kudoh, Tooru

AU - Nishimura, Shinichiro

AU - Oda, Megumi

AU - Yoshida, Makoto

AU - Komada, Yoshihiro

AU - Hara, Junichi

AU - Tawa, Akio

AU - Usami, Ikuya

AU - Tanizawa, Akihiko

AU - Kato, Koji

AU - Kobayashi, Ryoji

AU - Matsuo, Keitaro

AU - Hori, Hiroki

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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.

AB - 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.

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