Abstract
Background. Children with acute lymphoblastic leukemia (ALL) who fail to achieve complete remission (CR) after induction therapy (induction failure: IF) have a poor prognosis; however, there have been few prospective studies in patients with IF. Patients and Methods. Between April 1997 and March 2005, 27 of 1,237 leukemic patients (2.2%) failed to achieve CR after four- or five-drug induction therapy. Twenty-three of these patients entered the F-protocol study, which mainly consisted of acute-myeloid-leukemia-oriented chemotherapy followed by scheduled hematopoietic cell transplantation (HCT). Results. Seventeen (73.9%) of the 23 patients responded to re-induction chemotherapy with CR. Of note, 15 (93.8%) of 16 patients with Philadelphia-chromosome-negative (non-Ph+) ALL achieved CR; in contrast, only 2 (28.6%) of 7 Ph + patients achieved CR. Fourteen (82.4%) of 17 patients remained in CR (CCR) until their scheduled HCT, 12 of the 14 with CCR underwent HCT as scheduled, and 6 patients remain in first CR after a median of 78 months (range, 49-107 months). The 5-year overall survival (OS) rates of 16 patients with non-Ph+ and 7 patients with Ph+ were 43.8±12.4% and 14.3±13.2%, respectively (P=0.012). The 5-year OS rate of the 17 patients who obtained CR by re-induction therapy and the 6 who did not were 47.1±12.1% and 0%, respectively (P<0.001). Conclusion. Acute-myeloid-leukemia-oriented chemotherapy followed by scheduled HCT is a promising treatment strategy for non-Ph+ ALL patients with IF.
| Original language | English |
|---|---|
| Pages (from-to) | 71-78 |
| Number of pages | 8 |
| Journal | Pediatric Blood and Cancer |
| Volume | 54 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 1 2010 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Pediatrics, Perinatology, and Child Health
- Hematology
- Oncology
Cite this
Outcome of childhood acute lymphoblastic leukemia with induction failure treated by the Japan Association of Childhood Leukemia Study (JACLS) ALL F-protocol. / Suzuki, Nobuhiro; Yumura-Yagi, Keiko; Yoshida, Makoto; Hara, Junichi; Nishimura, Shinichiro; Kudoh, Tooru; Tawa, Akio; Usami, Ikuya; Tanizawa, Akihiko; Hori, Hiroki; Ito, Yasuhiko; Miyaji, Ryosuke; Oda, Megumi; Kato, Koji; Hamamoto, Kazuko; Osugi, Yuko; Hashii, Yoshiko; Nakahata, Tatsutoshi; Horibe, Keizo.
In: Pediatric Blood and Cancer, Vol. 54, No. 1, 01.01.2010, p. 71-78.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outcome of childhood acute lymphoblastic leukemia with induction failure treated by the Japan Association of Childhood Leukemia Study (JACLS) ALL F-protocol
AU - Suzuki, Nobuhiro
AU - Yumura-Yagi, Keiko
AU - Yoshida, Makoto
AU - Hara, Junichi
AU - Nishimura, Shinichiro
AU - Kudoh, Tooru
AU - Tawa, Akio
AU - Usami, Ikuya
AU - Tanizawa, Akihiko
AU - Hori, Hiroki
AU - Ito, Yasuhiko
AU - Miyaji, Ryosuke
AU - Oda, Megumi
AU - Kato, Koji
AU - Hamamoto, Kazuko
AU - Osugi, Yuko
AU - Hashii, Yoshiko
AU - Nakahata, Tatsutoshi
AU - Horibe, Keizo
PY - 2010/1/1
Y1 - 2010/1/1
N2 - Background. Children with acute lymphoblastic leukemia (ALL) who fail to achieve complete remission (CR) after induction therapy (induction failure: IF) have a poor prognosis; however, there have been few prospective studies in patients with IF. Patients and Methods. Between April 1997 and March 2005, 27 of 1,237 leukemic patients (2.2%) failed to achieve CR after four- or five-drug induction therapy. Twenty-three of these patients entered the F-protocol study, which mainly consisted of acute-myeloid-leukemia-oriented chemotherapy followed by scheduled hematopoietic cell transplantation (HCT). Results. Seventeen (73.9%) of the 23 patients responded to re-induction chemotherapy with CR. Of note, 15 (93.8%) of 16 patients with Philadelphia-chromosome-negative (non-Ph+) ALL achieved CR; in contrast, only 2 (28.6%) of 7 Ph + patients achieved CR. Fourteen (82.4%) of 17 patients remained in CR (CCR) until their scheduled HCT, 12 of the 14 with CCR underwent HCT as scheduled, and 6 patients remain in first CR after a median of 78 months (range, 49-107 months). The 5-year overall survival (OS) rates of 16 patients with non-Ph+ and 7 patients with Ph+ were 43.8±12.4% and 14.3±13.2%, respectively (P=0.012). The 5-year OS rate of the 17 patients who obtained CR by re-induction therapy and the 6 who did not were 47.1±12.1% and 0%, respectively (P<0.001). Conclusion. Acute-myeloid-leukemia-oriented chemotherapy followed by scheduled HCT is a promising treatment strategy for non-Ph+ ALL patients with IF.
AB - Background. Children with acute lymphoblastic leukemia (ALL) who fail to achieve complete remission (CR) after induction therapy (induction failure: IF) have a poor prognosis; however, there have been few prospective studies in patients with IF. Patients and Methods. Between April 1997 and March 2005, 27 of 1,237 leukemic patients (2.2%) failed to achieve CR after four- or five-drug induction therapy. Twenty-three of these patients entered the F-protocol study, which mainly consisted of acute-myeloid-leukemia-oriented chemotherapy followed by scheduled hematopoietic cell transplantation (HCT). Results. Seventeen (73.9%) of the 23 patients responded to re-induction chemotherapy with CR. Of note, 15 (93.8%) of 16 patients with Philadelphia-chromosome-negative (non-Ph+) ALL achieved CR; in contrast, only 2 (28.6%) of 7 Ph + patients achieved CR. Fourteen (82.4%) of 17 patients remained in CR (CCR) until their scheduled HCT, 12 of the 14 with CCR underwent HCT as scheduled, and 6 patients remain in first CR after a median of 78 months (range, 49-107 months). The 5-year overall survival (OS) rates of 16 patients with non-Ph+ and 7 patients with Ph+ were 43.8±12.4% and 14.3±13.2%, respectively (P=0.012). The 5-year OS rate of the 17 patients who obtained CR by re-induction therapy and the 6 who did not were 47.1±12.1% and 0%, respectively (P<0.001). Conclusion. Acute-myeloid-leukemia-oriented chemotherapy followed by scheduled HCT is a promising treatment strategy for non-Ph+ ALL patients with IF.
UR - http://www.scopus.com/inward/record.url?scp=73349127050&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=73349127050&partnerID=8YFLogxK
U2 - 10.1002/pbc.22217
DO - 10.1002/pbc.22217
M3 - Article
C2 - 19813250
AN - SCOPUS:73349127050
VL - 54
SP - 71
EP - 78
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
SN - 1545-5009
IS - 1
ER -